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静脉血栓栓塞症(VTE)是妊娠期间的一种常见疾病,是导致孕产妇死亡的最常见原因。孕妇VTE的发生率约为0.1%,孕产妇死亡的主要原因之一为肺栓塞。对妊娠VTE患者给予抗凝治疗可显著降低病死率并可减少再发VTE。妊娠时VTE的治疗和预防应使用低分子肝素或普通肝素,这两种药物不透过胎盘,因而避免了华法林的致畸风险。虽然在妊娠VTE患者中给予溶栓治疗的经验非常有限,但对大块肺栓塞和血流动力学严重受损的妊娠VTE患者给予溶栓治疗很可能起到挽救生命的作用。
VTE is a common disease during pregnancy and is the most common cause of maternal mortality. The incidence of VTE in pregnant women is about 0.1%. One of the major causes of maternal death is pulmonary embolism. Anticoagulant therapy in patients with pregnancy VTE can significantly reduce the mortality and reduce the recurrence of VTE. Treatment and prevention of VTE during pregnancy should use low molecular weight heparin or unfractionated heparin. Both drugs do not transmit through the placenta, thus avoiding the teratogenic risk of warfarin. Although there is only limited experience with thrombolytic therapy in patients with pregnancy VTE, thrombolytic therapy in patients with massive pulmonary embolism and severe hemodynamically impaired VTE may well be life-saving.