AlSheef Mohammed, Abuzied Yacoub, Alzahrani Ghady R, AlAraj Nihal, AlAqeel Nada, Aljishi Hala, Alomar Mukhtar J, Zaidi Abdul Rehman Z, Alarfaj Ohoud M
Internal Medicine and Thrombosis, Medical Specialties Department, King Fahad Medical City, Riyadh, SAU.
Nursing Department, Rehabilitation Hospital, King Fahad Medical City, Riyadh, SAU.
Cureus. 2022 Jun 12;14(6):e25865. doi: 10.7759/cureus.25865. eCollection 2022 Jun.
Background Combined oral contraceptives (COCs) are frequently prescribed for contraception, to regulate ovulation and treat endometriosis, and to control menopausal symptoms. A major risk of hormonal contraceptives is vascular thrombosis. Methods A retrospective chart review of female patients with deep vein thrombosis (DVT), pulmonary embolism (PE), or other sites of thrombosis or emboli seen in the thrombosis clinic of the department of internal medicine at a tertiary care hospital in Saudi Arabia between March 2010 and February 2015 was performed to identify and characterize which women were taking COCs. Results Of 1,008 patients treated for DVT, PE, or other sites of thrombosis or emboli, 100 (9.9%) were taking COCs. Venous (98%) and arterial (2%) thromboses were seen. Overall, 62% of the patients experienced a DVT and 26% pulmonary emboli, and 20% of the patients experienced unusual sites of thrombosis. Furthermore, 53% were obese or morbidly obese. The incidence of venous thrombosis was the highest during the first year of COC use (73%). Of the patients, 8% had thrombophilia. Conclusion This study characterizes Saudi women with thrombotic events taking COCs and identifies risk factors, including unusual sites of thrombosis. Most patients experienced the vascular event during the first year of taking COCs. Age of 40-50 years, obesity, and thrombophilia were the commonly observed risk factors.
背景 复方口服避孕药（COC）常用于避孕、调节排卵、治疗子宫内膜异位症以及控制更年期症状。激素避孕药的一个主要风险是血管血栓形成。方法 对2010年3月至2015年2月期间在沙特阿拉伯一家三级护理医院内科血栓门诊就诊的患有深静脉血栓形成（DVT）、肺栓塞（PE）或其他血栓或栓塞部位的女性患者进行回顾性病历审查，以确定并描述哪些女性正在服用COC。结果 在1008例接受DVT、PE或其他血栓或栓塞部位治疗的患者中，100例（9.9%）正在服用COC。观察到静脉血栓形成（98%）和动脉血栓形成（2%）。总体而言，62%的患者发生DVT，26%发生肺栓塞，20%的患者发生不常见的血栓形成部位。此外，53%为肥胖或病态肥胖。静脉血栓形成的发生率在使用COC的第一年最高（73%）。在这些患者中，8%患有血栓形成倾向。结论 本研究描述了服用COC发生血栓事件的沙特女性特征，并确定了风险因素，包括不常见的血栓形成部位。大多数患者在服用COC的第一年发生血管事件。40 - 50岁、肥胖和血栓形成倾向是常见的观察到的风险因素。
