孕产妇静脉血栓栓塞症59例临床分析

Clinical analysis of 59 cases of venous thromboembolism(VTE)in pregnancy and the puerperium

目的分析孕产妇静脉血栓栓塞症(venous thromboembolism,VTE)患者的发病特点、高危因素及妊娠期管理要点,改善孕产妇结局。方法回顾性分析2015年1月至2022年5月深圳市人民医院收治的59例孕产妇VTE患者(其中妊娠期VTE32例,产褥期VTE27例)的临床资料,包括VTE发病时间、发病部位、发病高危因素(如高龄、既往血栓史、自身免疫抗体异常、易栓症筛查异常、辅助生殖等)、孕产妇结局。结果本研究中孕产妇VTE发病时间常见于晚孕期及产褥期,发病部位以左下肢最常见,高龄、既往VTE病史、剖宫产、卧床≥48小时及易栓症是孕产妇VTE发病高危因素。经积极治疗,大部分结局预后良好。结论对所有孕产妇进行动态VTE评分、规范化筛查及规范治疗,能改善妊娠结局。

Objective To analyze the characteristics of maternal venous thromboembolism(VTE)patients,high-risk factors and management points in pregnancy and the puerperium to improve maternal outcomes.Methods The clinical data of 59 cases of VTE in pregnancy and the puerperium(consist of 32 VTE in pregnancy and 27 VTE in puerperium)admitted to the Shenzhen People's Hospital from January 2015 to May 2022 was retrospectively analyzed,including time of onset and position of VTE,high-risk factors(such as age greater than 35 years,history of thrombosis,autoimmune antibody abnormality,screening abnormality of susceptibility to embolism,assisted reproduction,etc.),maternal and perinatal outcome.Results Later trimester and puerperium were the common onset time of maternal VTE,and the site of onset was most common in the left lower limb.Age greater than 35 years,history of thrombosis,cesarean section,bedridden≥48 hours and thrombophilia were the risk factors for the onset of maternal VTE.After active treatment,most of the cases have a good prognosis.Conclusions Dynamic VTE scoring,standardized screening and standardized treatment of all pregnant women improves pregnancy outcomes.