国际妇产科学杂志

国际妇产科学杂志 ›› 2024, Vol. 51 ›› Issue (5): 556-559.doi: 10.12280/gjfckx.20240507

• 产科生理及产科疾病: 病例报告 • 上一篇    下一篇

妊娠早期肺栓塞一例

张铭, 王涵婷, 曹媛媛, 陈鲁杰, 王娟()   

  1. 261000 山东省潍坊市，山东第二医科大学附属医院（张铭，王涵婷，曹媛媛，王娟）；山东第二医科大学临床医学院（陈鲁杰）
  • 收稿日期:2024-05-30 出版日期:2024-10-15 发布日期:2024-10-17
  • 通讯作者: 王娟，E-mail：wangjuan0536@163.com

A Case of Early Pregnancy Pulmonary Embolism

ZHANG Ming, WANG Han-ting, CAO Yuan-yuan, CHEN Lu-jie, WANG Juan()   

  1. Affiliated Hospital of Shandong Second Medical University, Weifang 261000, Shandong Province, China (ZHANG Ming, WANG Han-ting, CAO Yuan-yuan, WANG Juan); School of Clinical Medicine, Shandong Second Medical University, Weifang 261000, Shandong Province, China (CHEN Lu-jie)
  • Received:2024-05-30 Published:2024-10-15 Online:2024-10-17
  • Contact: WANG Juan, E-mail: wangjuan0536@163.com

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摘要：

肺栓塞（pulmonary embolism）是一种严重的妊娠期并发症。该病发作突然，临床表现多样，易误诊，可通过计算机体层血管成像（computed tomography angiography，CTA）确诊。报道1例辅助生殖妊娠后，于孕40+ d出现心慌、胸闷、憋气，心脏彩色超声估计肺动脉压力63 mmHg（1 mmHg=0.133 kPa），行胸部CT+CTA后确诊为肺栓塞的病例。给予溶栓、抗凝及对症治疗后好转，行人工流产终止妊娠，现预后良好。报道此病例旨在提高临床医师对妊娠早期肺栓塞的警惕。除了仔细询问病史，临床医生还要及时进行相关的检验检查，以快速诊断并及时干预。

关键词: 肺栓塞, 妊娠初期, 妊娠并发症, 肺动脉高压, 生殖技术, 辅助

Abstract:

Pulmonary embolism is a serious complication during pregnancy. It presents suddenly with diverse clinical manifestations and is prone to misdiagnosis. Computed tomography angiography (CTA) is the definitive diagnostic tool. We report a case of pulmonary embolism diagnosed in a patient 40+ days into an assisted reproductive pregnancy, who presented with palpitations, chest tightness, and shortness of breath. Cardiac color Doppler ultrasound estimated the pulmonary artery pressure at 63 mmHg (1 mmHg=0.133 kPa). The diagnosis was confirmed after chest CT and CTA. The patient improved after thrombolytic, anticoagulant, and symptomatic treatment, followed by an induced abortion to terminate the pregnancy. The prognosis is currently favorable. This case aims to heighten clinical awareness of early pregnancy pulmonary embolism. Besides taking a detailed medical history, clinicians must promptly perform relevant tests and examinations to achieve a rapid diagnosis and timely intervention.

Key words: Pulmonary embolism, Pregnancy trimester, first, Pregnancy complications, Pulmonary arterial hypertension, Reproductive techniques, assisted