肥胖产妇肺栓塞抗凝治疗致出血1例  

Hemorrhage caused by anticoagulant therapy for pulmonary embolism in an obese parturient:a case report

作　　者：何继 HE Ji(Department of Obstetrics and Gynecology Critical Care Medicine,West China Second Hospital,Sichuan University,Key Laboratory of Birth Defects and Related Diseases of Women and Children,Ministry of Education,Sichuan Province,Chengdu 610041,China)

机构地区：[1]四川大学华西第二医院妇产科重症医学科,出生缺陷与相关妇儿疾病教育部重点实验室,四川成都610041

出　　处：《妇儿健康导刊》2022年第6期104-106,共3页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：本文报道1例28岁产妇,体重指数45.9 kg/m2,剖宫产术后第1天因血氧饱和度下降行CT肺血管造影检查确诊肺栓塞,予低分子肝素抗凝治疗,并监测抗Xa因子浓度以调整抗凝剂量,但在抗Xa因子尚未达到治疗浓度时即发生子宫切口血肿,经停止抗凝、中药治疗后血肿逐渐吸收,再次予低剂量低分子肝素抗凝治疗后患者康复。This article reports a 28-year-old woman with a body mass index of 45.9 kg/m2 who underwent CT pulmonary angiography on the first day after cesarean section and was diagnosed with pulmonary embolism due to decreased blood oxygen saturation.Anticoagulation therapy with low molecular weight heparin was prescribed,and the anti-factor Xa level was monitored to adjust the dose of low molecular weight heparin.Nevertheless,uterine incision hematoma occurred when the anti-factor Xa level had not reached the goal concentration.After stopping anticoagulation and traditional Chinese medicine treatment,the hematoma was gradually absorbed,and the patient recovered after lowdose low molecular weight heparin anticoagulation.

关 键 词：肥胖 肺栓塞 低分子肝素 抗XA因子 

分 类 号：R714.145[医药卫生—妇产科学]