妊娠早期深静脉血栓形成的诊断治疗报告

Diagnosis and Treatment of Deep Vein Thrombosis in Early Pregnancy

通过回顾性分析2020年1月1日-2021年12月31日期间某院诊治的2例妊娠早期合并下肢深静脉血栓患者的临床信息、病例特点、妊娠结局、治疗方案,并同时查阅大量国内外现有文献,发现妊娠早期深静脉血栓的相关病例罕见,仅有其他10例妊娠早期合并深静脉血栓的文献报道。总结分析所有病例的临床特点,发现妊娠早期合并下肢深静脉血栓无特异性临床表现,多因下肢肿胀、疼痛就诊,还可能表现为发热,可通过彩色血管多普勒检查辅助凝血功能检查确诊,在治疗方案上可根据病情选择单纯低分子肝素药物治疗或下腔静脉滤器置入术同时辅助低分子肝素药物治疗,尽早干预可减少并发症的发生,改善围产结局。妊娠是静脉血栓栓塞形成的高危因素之一,妊娠早期发生孕产妇深静脉血栓的案例罕见,但是需在妊娠早期提高对静脉血栓栓塞评估的重视,做到早发现、早识别、早干预、早治疗,减少深静脉血栓并发症的发生,改善围产结局。

From January 1st, 2020 to December 31st, 2021, the clinical information, case characteristics,pregnancy outcomes, and treatment plans of 2 patients with deep vein thrombosis of the lower extremities diagnosed and treated in a hospital in early pregnancy were retrospectively analyzed. At the same time, a large number of domestic and foreign patients were reviewed and a large number of domestic and foreign patients were reviewed. In the existing reports, the related cases of DVT in early pregnancy are rare, and only 10 other cases of DVT in early pregnancy have been reported. The clinical characteristics of all cases were summarized and analyzed, and it was found that there were no specific clinical manifestations of lower extremity deep venous thrombosis in early pregnancy. It was mostly due to lower extremity swelling and pain, and it might also manifested as fever. In terms of treatment plan, low-molecular-weight heparin drug therapy alone or inferior vena cava filter placement combined with low-molecular-weight heparin drug therapy can be selected according to the condition. Early intervention could reduce the occurrence of complications and improve perinatal outcomes. Pregnancy was one of the high-risk factors for venous thromboembolism. Maternal deep venous thrombosis in early pregnancy was rare, but it was necessary to improve the prevention of venous thromboembolism in early pregnancy.