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血栓形成倾向背景下的产后主动脉分叉血栓形成

Postpartum Aortic Bifurcation Thrombosis on the Background of Thrombophilic Disorder.

作者信息

Bohîltea Roxana Elena, Turcan Natalia, Muresian Horia, Condu Silvia, Bratila Elvira, Cîrstoiu Monica Mihaela

机构信息

"Carol Davila" University of Medicine and Pharmacy.

Obstetrics and Gynecology Department, University Emergency Hospital Bucharest.

出版信息

Maedica (Bucur). 2016 Sep;11(3):241-244.

Abstract

Two main causes of arterial thrombosis are known: fi rst - atherosclerosis, extensively studied, and the second - atrial fi brillation. The lack of any risk factors and the occurrence at young age of a thrombotic event requires us to investigate possible other conditions, including inherited thrombophilia that is represented by a series of genetic disorders that increase the risk of thromboembolic disease. The role of thrombophilia in the occurrence of arterial thrombosis is inconsequential; this disorder is characterized by the tendency of developing venous thrombosis. We present a rare case of a 29 year old woman that presents an arterial thrombotic event subsequent to the caesarean section. The patient had a positive familial history for thrombotic events and a cavernous sinus thrombosis in personal history. Prophylactic treatment with unfractionated heparin throughout pregnancy was applied. At 31 weeks gestation the patient underwent cesarean surgery for nonreassuring fetal status, 2 weeks fetal intrauterine growth restriction and absent diastolic fl ow of uterine arteries. Three days post operatory arterial thrombosis is suspected. The context that led to this suspicion was paresthesia, color modifi cation of the right leg and abolished popliteal pulse. Angiographic-CT confi rmed the presumptive diagnosis. A cardiovascular, conservatory treatment was successfully applied. Considering the particularities of the presented case we discuss the occurrence of arterial thrombosis postpartum in the context of confi rmed thrombophilia by reviewing the specialized literature.

摘要

已知动脉血栓形成的两个主要原因

一是动脉粥样硬化,对此已进行了广泛研究;二是心房颤动。缺乏任何危险因素且在年轻时发生血栓形成事件,这就要求我们调查可能的其他情况,包括遗传性易栓症,它表现为一系列会增加血栓栓塞性疾病风险的遗传紊乱。易栓症在动脉血栓形成中的作用并不重要;这种病症的特征是有形成静脉血栓的倾向。我们报告一例罕见病例,一名29岁女性在剖宫产术后发生动脉血栓形成事件。该患者有血栓形成事件的家族史,个人史中有海绵窦血栓形成。整个孕期应用了普通肝素进行预防性治疗。妊娠31周时,因胎儿状况不佳、胎儿宫内生长受限2周且子宫动脉舒张期血流消失,患者接受了剖宫产手术。术后三天怀疑发生了动脉血栓形成。引发这种怀疑的情况是感觉异常、右腿颜色改变以及腘动脉搏动消失。血管造影CT证实了初步诊断。成功实施了心血管保守治疗。考虑到该病例的特殊性,我们通过回顾专业文献,在确诊易栓症的背景下讨论产后动脉血栓形成的发生情况。

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Thrombophilia in pregnancy: a systematic review.妊娠期血栓形成倾向:一项系统评价。
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