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[孕期疑似深静脉血栓形成和肺栓塞的诊断]

[Diagnosis of suspected deep venous thrombosis and pulmonary embolism during pregnancy].

作者信息

Righini M, Bounameaux H

机构信息

Service d'angiologie et d'hémostase, Hôpital Universitaire de Genève, 1211 Genève 14.

出版信息

Rev Med Suisse. 2005 Jan 26;1(4):283, 286-9.

Abstract

Venous thromboembolic disease (VTE) is a frequent clinical problem during pregnancy and post-partum. Pulmonary embolism (PE) remains the most common cause of mortality during pregnancy and post-partum in western countries. In the majority of cases, DVT may be diagnosed by non-invasive tests such as clinical probability, D-dimer measurement and venous compression ultrasonography. In contrast, at least one irradiating invasive exam is necessary in suspected PE. The lung scan, the most validated diagnostic test for PE during pregnancy and fetal irradiation is quite low, in particular if only perfusion lung scan is used. Helical computed tomography (hCT) has widely replaced lung scan in the diagnostic approach of suspected pulmonary embolism. However, it has never been validated in pregnant women.

摘要

静脉血栓栓塞性疾病(VTE)是妊娠和产后常见的临床问题。在西方国家,肺栓塞(PE)仍然是妊娠和产后最常见的死亡原因。在大多数情况下,深静脉血栓形成(DVT)可通过临床概率、D-二聚体检测和静脉压迫超声等非侵入性检查来诊断。相比之下,疑似PE时至少需要进行一项有辐射的侵入性检查。肺扫描是妊娠期间诊断PE最有效的诊断方法,且胎儿辐射剂量相当低,特别是仅使用灌注肺扫描时。螺旋计算机断层扫描(hCT)在疑似肺栓塞的诊断方法中已广泛取代肺扫描。然而,它从未在孕妇中得到验证。

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