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目的提高对妊娠期肺栓塞的认识和诊疗水平。方法对上海市第六人民医院2009年2月至2016年9月收治的11例妊娠期肺栓塞患者进行回顾性分析。结果妊娠期肺栓塞的发病率4.4/万。6例发生于妊娠期,5例发生于分娩期。9例患者有呼吸困难和胸闷的表现;2例患者表现为突发晕厥、休克及低氧血症。5例同时存在下肢深静脉血栓。11例患者治疗成功率90.9%:8例抗凝治疗(治愈),2例小剂量溶栓治疗(治愈),1例常规剂量溶栓治疗(死亡)。结论增强对肺栓塞的诊断意识才能减少漏诊和误诊;CTPA是最有效的诊断手段;抗凝治疗是基础,建议小剂量溶栓治疗。
Objective To improve the understanding and diagnosis and treatment of pulmonary embolism during pregnancy. Methods A retrospective analysis was performed on 11 patients with pregnancy-induced pulmonary embolism who were admitted to the Sixth People’s Hospital of Shanghai from February 2009 to September 2016. Results The incidence of pulmonary embolism in pregnancy 4.4 / million. Six cases occurred during pregnancy and five occurred during childbirth. Nine patients had dyspnea and chest tightness; two patients had sudden syncope, shock, and hypoxemia. 5 cases of lower extremity deep vein thrombosis. The success rate of treatment in 11 patients was 90.9%: 8 cases of anticoagulant therapy (cure), 2 cases of low-dose thrombolysis (cure) and 1 case of conventional thrombolytic therapy (death). Conclusions It is suggested that CTPA is the most effective diagnostic method to reduce the misdiagnosis and missed diagnosis of pulmonary embolism. Anticoagulation therapy is the basis and small-dose thrombolysis is recommended.