O'Keeffe S A, McGrath A, Ryan J M, Byrne B
Department of Radiology, St James's Hospital, Dublin, Ireland.
J Matern Fetal Neonatal Med. 2008 Aug;21(8):591-4. doi: 10.1080/14767050802165604.
There are limited data available on the management of massive pulmonary embolism in pregnancy. The use of systemic thrombolysis has been reported, but there are few documented cases on the use of mechanical fragmentation or catheter-directed thrombolysis. Systemic thrombolysis in pregnancy increases the risk of major hemorrhage and there are reports of massive subchorionic hematomas following its use. We describe the use of mechanical fragmentation and optional retrievable inferior vena cava (IVC) filter insertion in a 38-week pregnant woman followed by delayed pharmacological catheter-directed thrombolysis during the early postpartum period to successfully treat a massive pulmonary embolism.
关于妊娠期间大面积肺栓塞的管理，可用数据有限。已有使用全身溶栓治疗的报道，但使用机械碎栓或导管定向溶栓的记录病例较少。妊娠期间进行全身溶栓会增加大出血风险，且有报道称使用后出现大量绒毛膜下血肿。我们描述了在一名38周孕妇中使用机械碎栓并选择性插入可回收下腔静脉（IVC）滤器，随后在产后早期进行延迟药物导管定向溶栓，成功治疗大面积肺栓塞的案例。
