妊娠合并复发性下肢静脉血栓伴家族性血栓病史一例并文献复习

A Case of Pregnancy Complicated with Recurrent Venous Thrombosis of Lower Limbs with a Family History of Thrombosis and Literature Review

分析吉林大学第二医院收治的1例妊娠合并复发性下肢静脉血栓伴家族性血栓病史病例的临床资料,并回顾分析既往相关文献及资料。妊娠妇女发生下肢静脉血栓栓塞症(VTE)风险是非妊娠妇女的5倍左右,既往下肢VTE史、家族性血栓病史均是VTE的高危因素。本例患者既往产褥期下肢静脉血栓溶栓治疗后再次复发,此次给予抗凝治疗后未出现不良后果。对于VTE高危型孕产妇,适当的抗凝治疗利大于弊,产褥期格外需要重视。如今剖宫产率的增加更提高了术后VTE发生的风险,因此产前的评估、产后的严密观察以及适当的抗凝治疗可以降低妊娠相关的复发性VTE发生率。

This article analyzes the clinical data of a case of recurrent venous thrombosis of the lower extremity with familial thrombosis in pregnancy admitted to the Second Hospital of Jilin University and retrospectively analyzes the relevant literatures as well as data in the past. The risk of venous thromboembolism (VTE) of lower extremity in pregnant women is about 5 times higher than that in non-pregnant women. The history of VTE in pregnant women and family history of VTE in pregnant women are the high risk factors of VTE. This patient had a recurrence after thrombolytic therapy for venous thrombosis in the lower extremity during the puerperium. No adverse effects were observed after this anticoagulant therapy. For VTE high-risk pregnant and lying-in women, appropriate anticoagulant therapy has more advantages than disadvantages, especially in puerperium. Moreover, the increased rate of cesarean section increases the risk of postoperative VTE. Therefore, prenatal evaluation, close observation after delivery and appropriate anticoagulation therapy can reduce the recurrence rate of pregnancy-related VTE.