中国医药科学
中國醫藥科學
중국의약과학
CHINA MEDICINE AND PHARMACY
2015年
6期
18-21,25
,共5页
围生期%深静脉血栓形成%预防%治疗
圍生期%深靜脈血栓形成%預防%治療
위생기%심정맥혈전형성%예방%치료
Perinatal period%Deep venous thrombosis%Prevention%Treatment
目的：探讨围生期静脉血栓栓塞症的诊治、预防措施及母婴预后。方法对广州医学院第三附属医院2009年1月~2014年1月42例围生期的临床资料进行回顾性分析。结果（1）其中37例多普勒彩色超声（88.1％）确诊,5例（11.9％）患者静脉彩色多普勒超声提示血栓形成阴性，行MRI提示血栓形成阳性确诊。左下肢血栓形成32例（76.2％），右下肢血栓形成9例（21.4％），双下肢血栓形成1例（2.4％），33例（78.6％）为中央型，3例（9.5％）为周围型，5例（11.9％）为混合型。（2）治疗：42例用低分子肝素抗凝治疗，11例行静脉滤器置入术，其中6例行插管溶栓，未有致死性肺栓塞发生，所有患者经系统治疗后均好转出院；行插管溶栓患者其72h、3个月、6个月血管再通情况均明显优于单纯抗凝患者，差异具有统计学意义（P＜0.05）。结论围生期是静脉血栓栓塞症的高发期，可致严重并发症，必须根据具体不同的孕期情况选择合适的治疗方案，在抗凝的基础上积极地溶栓处理，预防、减少并发症的发生，从而改善母婴的结局及减少深静脉血栓后遗症的发生。
目的：探討圍生期靜脈血栓栓塞癥的診治、預防措施及母嬰預後。方法對廣州醫學院第三附屬醫院2009年1月~2014年1月42例圍生期的臨床資料進行迴顧性分析。結果（1）其中37例多普勒綵色超聲（88.1％）確診,5例（11.9％）患者靜脈綵色多普勒超聲提示血栓形成陰性，行MRI提示血栓形成暘性確診。左下肢血栓形成32例（76.2％），右下肢血栓形成9例（21.4％），雙下肢血栓形成1例（2.4％），33例（78.6％）為中央型，3例（9.5％）為週圍型，5例（11.9％）為混閤型。（2）治療：42例用低分子肝素抗凝治療，11例行靜脈濾器置入術，其中6例行插管溶栓，未有緻死性肺栓塞髮生，所有患者經繫統治療後均好轉齣院；行插管溶栓患者其72h、3箇月、6箇月血管再通情況均明顯優于單純抗凝患者，差異具有統計學意義（P＜0.05）。結論圍生期是靜脈血栓栓塞癥的高髮期，可緻嚴重併髮癥，必鬚根據具體不同的孕期情況選擇閤適的治療方案，在抗凝的基礎上積極地溶栓處理，預防、減少併髮癥的髮生，從而改善母嬰的結跼及減少深靜脈血栓後遺癥的髮生。
목적：탐토위생기정맥혈전전새증적진치、예방조시급모영예후。방법대엄주의학원제삼부속의원2009년1월~2014년1월42례위생기적림상자료진행회고성분석。결과（1）기중37례다보륵채색초성（88.1％）학진,5례（11.9％）환자정맥채색다보륵초성제시혈전형성음성，행MRI제시혈전형성양성학진。좌하지혈전형성32례（76.2％），우하지혈전형성9례（21.4％），쌍하지혈전형성1례（2.4％），33례（78.6％）위중앙형，3례（9.5％）위주위형，5례（11.9％）위혼합형。（2）치료：42례용저분자간소항응치료，11례행정맥려기치입술，기중6례행삽관용전，미유치사성폐전새발생，소유환자경계통치료후균호전출원；행삽관용전환자기72h、3개월、6개월혈관재통정황균명현우우단순항응환자，차이구유통계학의의（P＜0.05）。결론위생기시정맥혈전전새증적고발기，가치엄중병발증，필수근거구체불동적잉기정황선택합괄적치료방안，재항응적기출상적겁지용전처리，예방、감소병발증적발생，종이개선모영적결국급감소심정맥혈전후유증적발생。
Objective To study the diagnosis and treatment, the preventive measures and the maternal-neonatal outcomes of VTE in perinatal period. Methods 42 cases with VTE in perinatal period who were treated in the Third Affiliated Hospital of Guangzhou Medical University between January 2009 and January 2014 were analyzed retrospectively. Results (1)37 cases (88.1%) were diagnosed with color Doppler imaging, 5 cases were diagnosed with MRI which suggested that thrombosis positive while color Doppler imaging suggested that thrombosis negative. There were 32 cases (76.2%) with thrombosis in left lower extremity, 9 cases (21.4%) with thrombosis in right lower extremity, 1 case (2.4%) with thrombosis in both lower limbs, 33 cases (78.6%)with central thrombosis, 3 cases (9.5%) with peripheral thrombosis and 5 cases (11.9%) with mixed thrombosis. (2)Treatment:42 cases were treated with anticoagulant therapy of low molecular weight heparin (LMWH), 11 cases were treated with inferior vena cava filters insertion, 6 cases were treated with catheter thrombolysis. There was no lethality pulmonary embolism, and all patients were improved and discharged after the systematic treatment. The situation of vascular recanalization in patients who were treated with catheter thrombolysis was better after 72 hours, 3 months and 6 months compared with which in patients who were treated with anticoagulation alone, there were statistical significance(P < 0.05). Conclusion VTE in perinatal period has high incidence, could induce severe complications, should be treated with appropriate therapy and thrombolysis based on anticoagulation through the specific different pregnancy to prevent and reduce the complication, in order to improve the maternal-neonatal outcomes and to reduce the sequela of deep venous thrombosis.
