摘要
目的探讨妊娠期下肢深静脉血栓形成(LDVT)的临床特点及治疗方法。方法回顾性分析山东大学附属省立医院血管外科自2006年8月到2010年10月收治的32例妊娠期发生LDVT患者的临床资料及治疗方法。结果 32例患者中,剖宫产17例,顺产2例,新生儿无畸形,阿氏评分均在8分以上;11例应患者要求中止妊娠,2例患者在治疗过程中流产。共有27例患者放置可回收下腔静脉滤器并最终全部取出。所有患者经治疗出院时患肢周径较健侧差异在(2±0.3)cm之内。本组无死亡,无肺栓塞发生,无出血并发症。平均随访(11±1.1)个月,随访期间行超声检查,17例患者下肢静脉仍存有静脉血栓,D-二聚体测定阴性,所有患者肢体症状无反复,未发现明显的症状性肺栓塞。结论妊娠期妇女合并LDVT,不推荐溶栓治疗;肝素、低分子肝素抗凝治疗安全有效;华法林在妊娠期禁用,在哺乳期可择情使用;严格掌握下腔静脉滤器置入的指征,不建议放置永久性滤器。
Objective To investigate clinical features and treatment of lower extremity deep venous thrombosis（LDVT） during the gestational period.Methods Clinical data and treatment methods of 32 patients with LDVT during the gestational period from August 2006 to October 2010 were retrospective analyzed.Results Among the patients,17 underwent cesarean section,and 2 underwent natural delivery.All neonates had an Apgar score of above 8 and no malformation was found.11 patients required termination of pregnancy and 2 aborted during treatment.27 patients had inferior vena cava filters placed and removed.All patients recovered well with the diameter difference between two legs within （2±0.3）cm.No death,pulmonary embolism or bleeding occurred.During 11±1.1 months of follow-up,venous thrombosis was found in 17 cases through Doppler,while D-dimers showed negativity.No recurrence or symptoms of pulmonary embolism occurred during follow-up.Conclusions For patients with LDVT during the gestational period, fibrinolytic therapy is not recommended.while heparin and low molecular weight heparin are safe and effective.Warfarin is forbidden in pregnancy but selectively used in lactation.The indication of inferior vena cava filter placement should be strictly controlled.Permanent inferior vena cava filter is not recommended.
出处
《山东大学学报（医学版）》
CAS
北大核心
2011年第10期143-145,共3页
Journal of Shandong University:Health Sciences
基金
山东省博士基金资助课题(2008BS03011)
关键词
妊娠期
下肢深静脉血栓形成
下腔静脉滤器
肺栓塞
Gestational period
Lower extremity deep venous thrombosis
Inferior vena cava filter
Pulmonary embolism
