协和医学杂志
協和醫學雜誌
협화의학잡지
Medical Journal of Peking Union Medical College Hospital
2015年
5期
352-356
,共5页
王文达%赵宇%彭萍%刘欣燕
王文達%趙宇%彭萍%劉訢燕
왕문체%조우%팽평%류흔연
妊娠%深静脉血栓形成%诊断%治疗%终止妊娠
妊娠%深靜脈血栓形成%診斷%治療%終止妊娠
임신%심정맥혈전형성%진단%치료%종지임신
pregnancy%deep venous thrombosis%diagnosis%treatment%termination of pregnancy
目的:探讨孕早期合并特殊部位深静脉血栓形成的临床特点、诊断和治疗。方法回顾性分析2013年9月至2014年6月在北京协和医院住院治疗的3例妊娠早期合并特殊部位深静脉血栓形成病例的临床表现、诊断、治疗及预后情况。结果1例妊娠合并肺栓塞、2例妊娠合并肠系膜-门静脉血栓形成,孕早期发病,对母亲及胎儿的预后影响大。血栓诊断首选多普勒超声,治疗同非孕期,以抗凝为主。3例均选择手术或药物流产。2例血栓稳定后药物流产终止妊娠顺利。1例于肠切除术后行钳刮术终止妊娠出血较多。结论孕早期合并特殊部位深静脉血栓形成罕见。其诊断应依靠临床表现及检查进行综合判断。抗凝治疗仍为关键,且不同部位深静脉血栓形成可能需要配合相应溶栓或手术治疗。如选择终止妊娠,血栓稳定后效果更佳。
目的:探討孕早期閤併特殊部位深靜脈血栓形成的臨床特點、診斷和治療。方法迴顧性分析2013年9月至2014年6月在北京協和醫院住院治療的3例妊娠早期閤併特殊部位深靜脈血栓形成病例的臨床錶現、診斷、治療及預後情況。結果1例妊娠閤併肺栓塞、2例妊娠閤併腸繫膜-門靜脈血栓形成,孕早期髮病,對母親及胎兒的預後影響大。血栓診斷首選多普勒超聲,治療同非孕期,以抗凝為主。3例均選擇手術或藥物流產。2例血栓穩定後藥物流產終止妊娠順利。1例于腸切除術後行鉗颳術終止妊娠齣血較多。結論孕早期閤併特殊部位深靜脈血栓形成罕見。其診斷應依靠臨床錶現及檢查進行綜閤判斷。抗凝治療仍為關鍵,且不同部位深靜脈血栓形成可能需要配閤相應溶栓或手術治療。如選擇終止妊娠,血栓穩定後效果更佳。
목적:탐토잉조기합병특수부위심정맥혈전형성적림상특점、진단화치료。방법회고성분석2013년9월지2014년6월재북경협화의원주원치료적3례임신조기합병특수부위심정맥혈전형성병례적림상표현、진단、치료급예후정황。결과1례임신합병폐전새、2례임신합병장계막-문정맥혈전형성,잉조기발병,대모친급태인적예후영향대。혈전진단수선다보륵초성,치료동비잉기,이항응위주。3례균선택수술혹약물유산。2례혈전은정후약물유산종지임신순리。1례우장절제술후행겸괄술종지임신출혈교다。결론잉조기합병특수부위심정맥혈전형성한견。기진단응의고림상표현급검사진행종합판단。항응치료잉위관건,차불동부위심정맥혈전형성가능수요배합상응용전혹수술치료。여선택종지임신,혈전은정후효과경가。
Objective To discuss the clinical features, diagnosis, and treatment of deep venous thrombo-sis at specific positions in first trimester of pregnancy. Methods Three cases in first trimester of pregnancy with deep venous thrombosis at specific positions treated in Peking Union Medical College Hospital in the period from September 2013 to June 2014 were retrospectively analyzed. The clinical manifestations, diagnosis, treatment, and prognosis of these cases were summarized. Results Among the 3 cases, 1 was pregnancy with pulmonary embolism and 2 were with mesenteric-portal venous thrombosis. All deep venous thrombosis occurred at first tri-mester of pregnancy and might have great effect on the prognosis of the maters and fetuses. Doppler ultrasound was the diagnosis method of option for thrombosis, and anticoagulation was the main therapeutic method, similar to the deep venous thrombosis in non-pregnancy. All the 3 patients chose surgical or medical abortion. The medi-cal abortion was performed successfully in 2 patients after the thrombus got stable, and forceps curettage was per-formed in 1 patient after enterectomy. Conclusions Deep venous thrombosis at specific positions in first trimes-ter is a rare condition. The diagnosis relies on clinical manifestations and examinations. Anticoagulation is the key in treatment, and deep venous thrombosis at different positions may need corresponding thrombolytic or surgical treatments. Abortion, if necessary, after stabilization of thrombus will lead to better outcomes.