Krishnamurthy P, Martin C B, Kay H H, Diesner J, Friday R O, Weber C A, Droste S
Department of Obstetrics, University of Wisconsin-Madison, 53715, USA.
J Matern Fetal Med. 1999 Jan-Feb;8(1):24-7. doi: 10.1002/(SICI)1520-6661(199901/02)8:1<24::AID-MFM6>3.0.CO;2-T.
Anticoagulation with intravenous heparin has been the standard treatment for the management of gestational thromboembolic complications. Catheter-directed thrombolysis is an encouraging approach for the treatment of thromboembolic disease and has not been previously reported during pregnancy. One gravid woman with pulmonary embolism, critically ill, and hemodynamically compromised, and two gravid women with iliofemoral venous thrombosis, who failed to respond to standard treatment with intravenous heparin, were treated with catheter-directed urokinase. All three patients experienced rapid resolution of symptoms and successful pregnancy outcomes. In our three patients, catheter-directed thrombolysis for thromboembolic disease during pregnancy allowed rapid resolution of hemodynamic abnormalities and/or resolution of thrombus. Catheter-directed thrombolysis offered a reasonably safe alternative to prolonged medical management in these young, otherwise healthy, patients. Long-term, it may prevent the postphlebitic syndrome.
静脉注射肝素进行抗凝一直是治疗妊娠期血栓栓塞并发症的标准方法。导管定向溶栓是治疗血栓栓塞性疾病的一种令人鼓舞的方法，此前在妊娠期尚未有报道。一名患有肺栓塞、病情危重且血流动力学不稳定的孕妇，以及两名对静脉注射肝素标准治疗无反应的髂股静脉血栓形成孕妇，接受了导管定向尿激酶治疗。所有三名患者的症状均迅速缓解，妊娠结局良好。在我们的三名患者中，妊娠期血栓栓塞性疾病的导管定向溶栓使血流动力学异常迅速缓解和/或血栓溶解。对于这些年轻、健康的患者，导管定向溶栓为长期药物治疗提供了一种相对安全的替代方法。从长远来看，它可能预防血栓形成后综合征。
