产后卵巢静脉合并下腔静脉血栓形成1例并文献复习  

Postpartum ovarian vein with inferior vena cava thrombosis:a case report and literature review

作　　者：袁馨 李艳 罗丹 郑佳欣 杨冯棱 唐冬梅 Yuan Xin;Li Yan;Luo Dan;Zheng Jiaxin;Yang Fengleng;Tang Dongmei(Department of Obstetrics,the Affiliated Women's and Children's Hospital,School of Medicine,University of Electronic Science and Technology of China(Chengdu Women's and Children's Central Hospital),Chengdu 610073,China;Department of Imaging,the Affiliated Women's and Children's Hospital,School of Medicine,University of Electronic Science and Technology of China(Chengdu Women's and Children's Central Hospital),Chengdu 610073,China)

机构地区：[1]电子科技大学医学院附属妇女儿童医院(成都市妇女儿童中心医院)产科,成都610073 [2]电子科技大学医学院附属妇女儿童医院(成都市妇女儿童中心医院)影像科,成都610073

出　　处：《中华围产医学杂志》2024年第12期1049-1053,共5页Chinese Journal of Perinatal Medicine

摘　　要：目的探讨产后卵巢静脉合并下腔静脉血栓形成的临床特征及诊疗。方法回顾性分析电子科技大学医学院附属妇女儿童医院(成都市妇女儿童中心医院)产科诊治的1例产后卵巢静脉合并下腔静脉血栓形成病例的临床资料。在中国知网、万方数据库、中华医学期刊全文数据库和维普数据库以“卵巢静脉血栓”“下腔静脉血栓”和“妊娠”为关键词检索中文文献;在PubMed、Embase和UpToDate数据库以“ovarian vein thrombosis”“inferior vena cava”和“pregnancy”为关键词检索英文文献。检索时间为1995年1月至2024年1月。排除标准:(1)卵巢静脉血栓未合并下腔静脉血栓者;(2)临床资料不全者。分析这些病例的临床特征、诊治经过及预后。对数据资料采用描述性统计分析。结果(1)病例报告:患者31岁,因“臀位、胎膜早破”足月剖宫产手术,术后3 d出现腹痛、右侧腰痛不适,无发热,B超提示双肾盂分离,CT血管造影提示右侧卵巢静脉血栓+下腔静脉血栓形成,转入四川大学华西医院血管外科,予那曲肝素等抗凝治疗10 d后病情稳定出院。出院继续口服利伐沙班抗凝。出院3个月后随访,患者未诉明显不适。(2)文献复习:检索获得文献20篇(英文18篇、中文2篇),共21例患者。加上本单位收治的该例患者,共计22例。22例患者平均年龄为(29.7±2.5)岁,范围为16~39岁;产后发病时间为(6.2±1.9)d,范围为1~30 d;16例(72.7%)剖宫产,6例(27.3%)经阴道分娩(包括产钳助产1例);14例(63.6%)为右侧卵巢静脉合并下腔静脉血栓,8例(36.4%)合并肺栓塞及其他部位深静脉血栓。22例患者的症状包括发热(14例,63.6%)、下腹痛(16例,72.7%)、腰痛和胸背痛(各3例,13.6%)、呼吸困难(2例,9.1%),以及咳嗽和晕厥(各1例,4.5%)。5例患者通过超声初步诊断,22例患者通过CT确诊。9例患者报告了发病时D-二聚体水平,为(2.74±1.01)mg/L。22例患者的治疗方式包括抗ObjectiveTo investigate the clinical characteristics,diagnosis,treatment,and prognosis of postpartum ovarian vein thrombosis(OVT)combined with inferior vena cava thrombosis(IVCT).MethodsA retrospective analysis was conducted on the clinical data of a postpartum OVT case combined with IVCT treated in the Department of Obstetrics of the Affiliated Women's and Children's Hospital,School of Medicine,University of Electronic Science and Technology of China(Chengdu Women and Children's Central Hospital).Chinese literature was searched in CNKI,Wanfang Database,Yiigle,and VIP Database using the keywords"ovarian vein thrombosis,""inferior vena cava thrombosis,"and"pregnancy."English literature was searched using the same keywords in PubMed,Embase,and UpToDate databases.The search period was from January 1995 to January 2024.Exclusion criteria were:(1)OVT not combined with IVCT;(2)incomplete clinical data.These cases'clinical characteristics,diagnosis,treatment,and prognosis were analyzed using a descriptive statistical analysis.Results(1)Case report:The patient,a 31-year-old woman,underwent a full-term cesarean section due to breech presentation and premature rupture of membranes.Three days postoperatively,she developed abdominal pain and right-sided back pain without fever.Ultrasound indicated bilateral renal pelvis separation,and CT angiography revealed right OVT combined with IVCT.She was transferred to the Vascular Surgery Department of West China Hospital,Sichuan University,where she received anticoagulant therapy with nadroparin for 10 days and was discharged in stable condition.She continued oral rivaroxaban anticoagulation therapy after discharge.At a three-month follow-up,the patient reported no discomfort.(2)Literature review:Twenty articles(18 in English and two in Chinese)involving 21 patients were identified.Including the case from our hospital,there were 22 cases in total.The average age of the 22 patients was(29.7±2.5)years,ranging from 16 to 39 years.The onset of the condition postpartum was(6.2±1.9)days

关 键 词：静脉血栓形成 卵巢 腔静脉 下 肺栓塞 妊娠并发症 

分 类 号：R711.75[医药卫生—妇产科学]