Kolacki Christian, Rocco Vito
William Beaumont Hospital, Royal Oak, MI, USA.
J Emerg Med. 2012 Apr;42(4):413-6. doi: 10.1016/j.jemermed.2011.06.011. Epub 2011 Sep 25.
Combined oral contraceptives are known to confer a risk of venous thromboembolism, including cerebral venous sinus thrombosis (CVST), to otherwise healthy women. NuvaRing (Organon USA, Inc., Roseland, NJ) is a contraceptive vaginal ring that delivers 120 μg of etonogestrel and 15 μg of ethinyl estradiol per day. Its use has been associated with rare venous thromboembolic events, but few cases of CVST associated with NuvaRing have been reported.
To describe a case that illustrates the increased risk of CVST associated with use of NuvaRing. We describe the case of a NuvaRing user who presented to our emergency department with a headache, who was diagnosed with CVST.
Evidence suggests that NuvaRing has at least as much prothrombotic potential as combined oral contraceptives. Thus, emergency physicians should suspect serious venous thromboembolic events, including CVST, deep venous thrombosis, and pulmonary embolism, in NuvaRing users in the proper clinical setting.
已知复方口服避孕药会使原本健康的女性面临静脉血栓栓塞风险，包括脑静脉窦血栓形成（CVST）。优思明阴道环（美国欧加农公司，新泽西州罗斯兰）是一种阴道避孕环，每天释放120微克依托孕烯和15微克炔雌醇。其使用与罕见的静脉血栓栓塞事件有关，但与优思明阴道环相关的CVST病例报告较少。
描述一例说明使用优思明阴道环会增加CVST风险的病例。我们描述了一名因头痛到急诊科就诊的优思明阴道环使用者，其被诊断为CVST。
有证据表明，优思明阴道环至少与复方口服避孕药具有同样的促血栓形成潜力。因此，在适当的临床环境中，急诊医生应怀疑优思明阴道环使用者发生严重静脉血栓栓塞事件，包括CVST、深静脉血栓形成和肺栓塞。
