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在怀孕的第二个三个月期间,针对亚大规模肺栓塞的大孔吸血栓切除术:一个病例报告
Pipin Kojodjojo1, Chin Hin Ng2, Kymin Cayla Ong1
1Asian Heart & Vascular Centre, 3 Mount Elizabeth, #10-14, Singapore 228510, Singapore.
European heart journal. Case reports
|November 9, 2023
概括
怀孕相关的肺栓塞 (PE) 可能具有挑战性. 大孔吸血栓切除术为高风险病例提供了血栓溶解或手术的安全有效替代方案,改善了母亲和胎儿的结果.
科学领域:
- 心脏病学 心脏病学
- 产科 产科 产科 产科 产科
- 血管外科 血管外科
背景情况:
- 怀孕相关的肺栓塞 (PAPE) 是导致产妇死亡的主要原因.
- 抗凝药是大多数孕妇PE的标准,但在血液动力学上受损或耐火的情况下具有挑战性.
- 系统性血栓溶解带有严重的母亲出血和胎儿损失的风险.
研究的目的:
- 评估大孔吸血血栓切除术在管理高风险妊娠相关肺栓塞时的有效性和安全性.
- 介绍一个孕妇患者抗凝固药不耐药的案例研究,她成功接受了吸血栓切除术.
主要方法:
- 介绍了一个怀孕第二个三个月的初怀孕患者的病例,患有耐火性深静脉血栓症和亚大规模肺栓塞.
- 一个多学科团队讨论了管理选择.
- 患者接受了大孔吸血栓切除术.
主要成果:
- 实现了完全的血栓去除.
- 肺压力和右心压力正常化.
- 该程序避免了需要使用血栓抑制剂或手术的需要,血液损失最小.
- 患者在手术后不久就出院了,并按期分娩了一个健康的婴儿.
结论:
- 与血栓溶解或手术相比,吸血栓切除术是高风险PAPE的可行和潜在的更安全的选择.
- 这种技术可以显著降低与PAPE相关的孕产妇和胎儿死亡率.
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