王文达;赵宇;彭萍;刘欣燕;
WANG Wen-da;ZHAO Yu;PENG Ping;LIU Xin-yan;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

• 1:中国医学科学院北京协和医学院北京协和医院妇产科

摘要(Abstract)：

目的探讨孕早期合并特殊部位深静脉血栓形成的临床特点、诊断和治疗。方法回顾性分析2013年9月至2014年6月在北京协和医院住院治疗的3例妊娠早期合并特殊部位深静脉血栓形成病例的临床表现、诊断、治疗及预后情况。结果 1例妊娠合并肺栓塞、2例妊娠合并肠系膜-门静脉血栓形成,孕早期发病,对母亲及胎儿的预后影响大。血栓诊断首选多普勒超声,治疗同非孕期,以抗凝为主。3例均选择手术或药物流产。2例血栓稳定后药物流产终止妊娠顺利。1例于肠切除术后行钳刮术终止妊娠出血较多。结论孕早期合并特殊部位深静脉血栓形成罕见。其诊断应依靠临床表现及检查进行综合判断。抗凝治疗仍为关键,且不同部位深静脉血栓形成可能需要配合相应溶栓或手术治疗。如选择终止妊娠,血栓稳定后效果更佳。
Objective To discuss the clinical features,diagnosis,and treatment of deep venous thrombosis at specific positions in first trimester of pregnancy. Methods Three cases in first trimester of pregnancy with deep venous thrombosis at specific positions treated in Peking Union Medical College Hospital in the period from September 2013 to June 2014 were retrospectively analyzed. The clinical manifestations,diagnosis,treatment,and prognosis of these cases were summarized. Results Among the 3 cases,1 was pregnancy with pulmonary embolism and 2 were with mesenteric-portal venous thrombosis. All deep venous thrombosis occurred at first trimester of pregnancy and might have great effect on the prognosis of the maters and fetuses. Doppler ultrasound was the diagnosis method of option for thrombosis,and anticoagulation was the main therapeutic method,similar to the deep venous thrombosis in non-pregnancy. All the 3 patients chose surgical or medical abortion. The medical abortion was performed successfully in 2 patients after the thrombus got stable,and forceps curettage was performed in 1 patient after enterectomy. Conclusions Deep venous thrombosis at specific positions in first trimester is a rare condition. The diagnosis relies on clinical manifestations and examinations. Anticoagulation is the key in treatment,and deep venous thrombosis at different positions may need corresponding thrombolytic or surgicaltreatments. Abortion,if necessary,after stabilization of thrombus will lead to better outcomes.

关键词(KeyWords)： 妊娠;深静脉血栓形成;诊断;治疗;终止妊娠
pregnancy;deep venous thrombosis;diagnosis;treatment;termination of pregnancy

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 王文达;赵宇;彭萍;刘欣燕;
WANG Wen-da;ZHAO Yu;PENG Ping;LIU Xin-yan;Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College;

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