Kramer W B, Belfort M, Saade G R, Surani S, Moise K J
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA.
Obstet Gynecol. 1995 Oct;86(4 Pt 2):660-2. doi: 10.1016/0029-7844(95)00121-7.
Thrombolytic agents have been used successfully to treat patients with massive pulmonary embolism and cardiorespiratory insufficiency, but experience with these drugs in pregnancy is limited.
A 20-year-old woman at 21 weeks' gestation was admitted with a massive pulmonary embolism. She was initially given intravenous heparin therapy but because of worsening clinical condition, urokinase was used. After two 12-hour periods of therapy, the urokinase was discontinued and the heparin restarted. She remained on subcutaneous heparin therapy for the remainder of her pregnancy, which was otherwise uncomplicated. She delivered a healthy male infant at term without complications and was discharged on warfarin therapy.
Thrombolytic therapy can be life-saving and should be considered in the treatment of hemodynamically significant pulmonary embolism in pregnancy.
溶栓药物已成功用于治疗大面积肺栓塞和心肺功能不全的患者，但这些药物在妊娠期的应用经验有限。
一名妊娠21周的20岁女性因大面积肺栓塞入院。她最初接受静脉肝素治疗，但由于临床状况恶化，使用了尿激酶。经过两个12小时的治疗期后，停用尿激酶并重新开始使用肝素。她在孕期剩余时间继续接受皮下肝素治疗，孕期其他方面未出现并发症。她足月分娩了一名健康男婴，无并发症，并在华法林治疗后出院。
溶栓治疗可挽救生命，在治疗妊娠期血流动力学显著的肺栓塞时应予以考虑。
