大面积肺血栓栓塞症的孕妇溶栓治疗对胎儿的影响1例报道  

Effects of thrombolytic therapy on pregnant women with massive pulmonary embolism and on their fetuses： case study

作　　者：夏书月[1] 刘伟[2] 鲍春英[1] 刘放[1] 臧桐[3] 王实[1] 

机构地区：[1]沈阳医学院奉天医院呼吸与危重症医学科,110024 [2]沈阳医学院奉天医院妇产科,110024 [3]沈阳医学院奉天医院影像科,110024

出　　处：《国际呼吸杂志》2012年第10期755-759,共5页International Journal of Respiration

摘　　要：目的探讨患有肺血栓栓塞症的孕妇的诊断和治疗。方法我院收治1例大面积肺血栓栓塞症的孕妇，根据临床表现，进行超声心动图，相应的实验室检查方法，给予溶栓和抗凝治疗。结果心脏超声提示：左肺动脉内回声：栓子？三尖瓣轻度反流，肺动脉高压，肺动脉瓣少量反流，主肺动脉增宽。心电图：QⅢTⅢ现象。低氧血症。行溶栓和抗凝治疗，随后胎儿B超显示胎儿心跳正常，胎盘宫底，羊水深度3．5cm，内透声清。终止孕娠而获得胎儿的心、肺病理学观察，无异常改变．孕妇无出血等并发症发生，1个月后出院。结论孕娠早期合并肺栓塞时，超声心动图、实验窀和临床资料可以作出快速诊断和治疗的决定。患有致命性肺栓塞的孕妇，溶栓治疗不应该因怀孕而被禁用。Objective To study the diagnosis and treatment of pregnant women with puhnonary embolism. Methods A pregnant woman with pulmonary embolism according to clinical manifestations, echocardiography, and laboratory screening method was cured by thrombolytic therapy. Results Echocardiography showed artery echo in left lung. Embolism, mild backflow in the tricuspid valve, pulmonary hypertension, a small amount of regurgitation in the pulmonary valve, and widening of the main pulmonary artery were observed. ECG： QIII TIII Ultrasound showed that the fetal heartbeat was normal after thrombolysis and anticoagulation therapy. The amniotic fluid index was 3.5 cm and clear. After artificial induction, the fetal heart and lungs were found to be normal under pathological examination. The patient experienced no hemorrhaging or other complications. After one month, the patient was discharged from the hospital. Conclusions Thrombolytic therapy is useful for pregnant women with massive pulmonary embolism. With echocardiography, ultrasound, laboratory testing, and clinical manifestation, fast diagnoses and early treatment become possible.

关 键 词：超声诊断 抗栓治疗 妊娠 肺血栓栓塞症 

分 类 号：R563.5[医药卫生—呼吸系统]