Ho Vy T, Dua Anahita, Lavingia Kedar, Rothenberg Kara, Rao Christina, Desai Sapan S
1 Division of Vascular Surgery, Department of Surgery, Stanford Health Care, Stanford, CA, USA.
2 Department of Surgery, University of California San Francisco-East Bay, San Francisco, CA, USA.
Vasc Endovascular Surg. 2018 Oct;52(7):527-534. doi: 10.1177/1538574418777822. Epub 2018 May 27.
Pregnancy is a hypercoagulable state, conferring an increased risk of venous thromboembolism (VTE). However, treatment algorithms for deep venous thrombosis and pulmonary embolism are based on studies of nonpregnant patients.
A literature review of cases in which thrombolysis was used for the treatment of VTE during pregnancy was conducted using the PubMed (National Institutes of Health) database.
A PubMed database search of English language articles for reports of thrombolysis for the treatment of VTE in pregnancy identified 215 cases, including 183 cases of systemic thrombolysis, 19 cases of catheter-directed thrombolysis, and 13 cases of mechanical thrombectomy. For systemic thrombolysis, the maternal complication rate was 4.40% and the fetal complication rate was 1.65%. For catheter-directed thrombolysis, the maternal complication rate was 14.75% and the fetal complication rate was 5.2%. In cases of mechanical thrombectomy, there were no reported maternal or fetal complications.
Although conservative strategies are preferred in pregnancy, thrombolysis is an adjunct for limb or life-threatening VTE. Review of past reports suggests low rates of maternal and fetal complications following systemic thrombolysis and mechanical thrombectomy but higher rates of complications after catheter-directed thrombolysis in the treatment of VTE during pregnancy.
妊娠是一种高凝状态，会增加静脉血栓栓塞症（VTE）的风险。然而，深静脉血栓形成和肺栓塞的治疗方案是基于对非妊娠患者的研究制定的。
使用美国国立医学图书馆的PubMed数据库对妊娠期间使用溶栓治疗VTE的病例进行文献综述。
在PubMed数据库中搜索关于妊娠期间使用溶栓治疗VTE的英文文献，共识别出215例病例，其中包括183例全身溶栓、19例导管定向溶栓和13例机械血栓切除术。全身溶栓的母体并发症发生率为4.40%，胎儿并发症发生率为1.65%。导管定向溶栓的母体并发症发生率为14.75%，胎儿并发症发生率为5.2%。在机械血栓切除术中，未报告母体或胎儿并发症。
虽然妊娠期间首选保守策略，但溶栓是治疗肢体或危及生命的VTE的辅助手段。对既往报告的回顾表明，妊娠期间治疗VTE时，全身溶栓和机械血栓切除术后母体和胎儿并发症发生率较低，但导管定向溶栓后并发症发生率较高。
