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中华产科急救电子杂志 ›› 2014, Vol. 03 ›› Issue (02) : 90 -95. doi: 10.3877/cma.j.issn.2095-3259.2014.02.004

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妊娠期肺栓塞的预防与处理
朱洁萍1, 滕银成1,()   
  1. 1. 200233 上海交通大学附属第六人民医院妇产科
  • 收稿日期:2014-04-05 出版日期:2014-05-18
  • 通信作者: 滕银成

Prophylaxis and treatment for pulmonary embolism in pregnancy

Jieping Zhu1, Yincheng Teng1()   

  • Received:2014-04-05 Published:2014-05-18
  • Corresponding author: Yincheng Teng
引用本文:

朱洁萍, 滕银成. 妊娠期肺栓塞的预防与处理[J/OL]. 中华产科急救电子杂志, 2014, 03(02): 90-95.

Jieping Zhu, Yincheng Teng. Prophylaxis and treatment for pulmonary embolism in pregnancy[J/OL]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2014, 03(02): 90-95.

孕妇是肺栓塞的高发人群,遗传性或获得性易栓症等因素的存在更增加了发病风险。妊娠期的生理性改变和胎儿因素,使妊娠期肺栓塞的诊断变得复杂和困难。治疗首选低分子量肝素,溶栓治疗须严格掌握适应证和禁忌证。

Pregnant women are at high risk of developing pulmonary embolism. The genetic and acquired thrombophilia may increase the risk of pulmonary embolism. Physiological changes during pregnancy and concerning of the fetus make the diagnosis and treatment of pulmonary embolism more complicated. Low molecular weight heparin is the preferred medicine for pulmonary embolism. It is important to strictly adhere to the indications and the contraindications for thrombolytic therapy.

表1 不同遗传因素导致血栓形成的相对危险度[4]
表2 妊娠期改良Wells评分法[10]
图1 妊娠期可疑肺栓塞的诊断路径。CTPA :CT肺血管成像;V/Q:肺通气/灌注扫描
表3 不同放射性检查时胎儿的射线暴露剂量[13]
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