妊娠期急性肺动脉栓塞11例病例分析

发布时间：2018-03-27 19:52

本文选题：妊娠　切入点：肺栓塞　出处：《中国妇产科临床杂志》2017年05期

【摘要】：目的提高对妊娠期肺栓塞的认识和诊疗水平。方法对上海市第六人民医院2009年2月至2016年9月收治的11例妊娠期肺栓塞患者进行回顾性分析。结果妊娠期肺栓塞的发病率4.4/万。6例发生于妊娠期,5例发生于分娩期。9例患者有呼吸困难和胸闷的表现;2例患者表现为突发晕厥、休克及低氧血症。5例同时存在下肢深静脉血栓。11例患者治疗成功率90.9%:8例抗凝治疗(治愈),2例小剂量溶栓治疗(治愈),1例常规剂量溶栓治疗(死亡)。结论增强对肺栓塞的诊断意识才能减少漏诊和误诊;CTPA是最有效的诊断手段;抗凝治疗是基础,建议小剂量溶栓治疗。
[Abstract]:Objective to improve the understanding and diagnosis and treatment of pulmonary embolism in pregnancy. Methods 11 cases of pulmonary embolism complicating pregnancy in Shanghai sixth people's Hospital from February 2009 to September 2016 were retrospectively analyzed. The incidence rate of 4 4 / 10 6 cases occurred in pregnancy and 5 cases occurred in childbirth. 2 cases had dyspnea and chest tightness, 2 cases had sudden syncope, 2 cases had dyspnea and chest tightness, 2 cases had sudden syncope, 2 cases had dyspnea and chest tightness. The success rate of anticoagulant therapy in 8 patients with shock and hypoxemia was 90.9: 8 (2 cases with low dose thrombolytic therapy) (1 case with routine thrombolytic therapy). Only the diagnosis consciousness of embolism can reduce missed diagnosis and misdiagnosis CTPA is the most effective diagnostic method. Anticoagulant therapy is the basis and low dose thrombolytic therapy is recommended.
【作者单位】：上海交通大学附属第六人民医院上海市产科重症监护中心妇产科研究所;
【基金】：国家自然科学基金面上项目(81570444) 国家科技部“十二五”支撑计划项目(2014BAI05B05) 上海市卫计委第四轮公共卫生行动计划重点学科建设计划(15GWZK0701)
【分类号】：R714.253

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