子宫腺肌病合并肺栓塞临床特点分析及治疗方式选择

Clinical Characteristics and Treatment Optionsof Adenomyosis with Pulmonary Embolism

探讨子宫腺肌病合并肺栓塞的临床特点,分析两者关系。回顾性分析中国医科大学附属盛京医院2014年12月至2017年12月收治的子宫腺肌病合并肺栓塞患者6例。结果6例患者中处于经期5例,围绝经期1例,低危3例,中低危3例。发病年龄43岁～52岁[(48.33±3.83)岁],体质量指数(BMI)(29.15±2.37)kg/m2,子宫腺肌病病程12个月～24个月[(16.67±5.89)个月],肺栓塞病程为入院前16个月至入院后2天,6例患者均无明显的肺栓塞高危因素。5例患者CA125高于正常,6例患者全部贫血,肺通气灌注显像和CT肺动脉造影提示6例患者均有不同程度肺动脉栓塞,其中5例双侧肺动脉栓塞,1例右侧肺动脉栓塞。子宫腺肌病是一种"易栓症",在其病程中应时刻警惕肺栓塞形成,贫血、CA125升高可使血栓形成风险提高。

To investigate the clinical characteristics of adenomyosis with pulmonary embolism and analyze the relationship between them.A retrospective analysis of six cases with adenomyosis and pulmonary embolism admitted to shengjing hospital of China medical university from December 2014 to December 2017.Among the 6 cases,5 were in menstrual period,1 was in perimenopausal period,3 were in low risk and 3 were in moderate low risk.Onset ages were from 43 to 52(48.33±3.83)years of age,body mass index BMI was from(29.15±2.37)Kg/m^2,adenomyosis courses were from 12 to 24(16.67±5.89)months,pulmonary embolism courses were from 16 months prior to and 2 days after admission to the hospital,6 cases had no obvious risk factors.CA125 of 5 cases were higher than normal,all 6 cases were anemic.Pulmonary ventilation perfusion imaging and CT pulmonary angiography showed that 6 patients had different degree of pulmonary artery embolism,including 5 patients with bilateral pulmonary artery embolism and 1 patient with right pulmonary artery embolism.Conclusions Adenomyosis is a kind of"thrombolytic disease",it is vigilant for the formation of pulmonary embolism.anemia and CA125 elevation can increase the risk of thrombosis.