摘要
目的:分析子宫腺肌病合并静脉血栓栓塞症的临床特征,提高医生对子宫腺肌病合并静脉血栓栓塞症的认识。方法:回顾性分析1例子宫腺肌病合并静脉血栓栓塞症患者的临床特征,并结合文献进行复习。以“子宫腺肌病,肺血栓栓塞症,肺栓塞,深静脉血栓形成,静脉血栓栓塞症”为中文检索词在万方数据库、中文期刊全文数据库进行检索,以“adenomyosis、pulmonary thromboembolism、pulmonary embolism、deep vein thrombosis、venous thromboembolism”为英文检索词在PubMed进行检索。结果:患者女性,55岁,因活动后胸闷、憋气10余天入院。既往诊断子宫腺肌病6年,近1个月因子宫出血口服去氧孕烯炔雌醇片治疗。D-Dimer1904μg/L。心电图:V1~V5导联轻微ST段异常和T波倒置。UCG:肺动脉收缩压77mmHg(1 mmHg=0.133kPa),右心增大,三尖瓣反流峰值流速4.12m/s,肺动脉主干及分支增宽。肺动脉CTA示多发肺栓塞,累及双侧肺动脉分支。下肢静脉超声示右侧股总静脉血栓形成,双侧胫后静脉及小腿肌间静脉血栓形成。诊断急性肺血栓栓塞症,下肢深静脉血栓形成,子宫腺肌病。行下腔静脉滤器置入术及子宫分段诊刮术后给与抗凝治疗。共检索出含病例资料的文献7篇,其中中文1篇,英文6篇,涉及病例数16例。结论:子宫腺肌病合并静脉血栓栓塞症在临床并不常见,且治疗存在矛盾。此外,子宫腺肌病可能作为危险因素诱发静脉血栓栓塞症。
Objective:To analyze the clinical features of adenomyosis with venous thromboembolism,and to improve doctors'understanding of adenomyosis with venous thromboembolism.Methods:A case of adenomyosis with venous thromboembolism was retrospectively analyzed and the related literature was reviewed.Results:The patient was a 55-year-old female with chest distress and breath-holding for more than 10 days.Previously diagnosed with adenomyosis for 6 years,she was treated with desogestrel and ethinylestradiol tablets for metrorrhagia in recent 1 month.D-Dimer1904μg/L.ECG showed slight ST segment abnormality and T wave inversion in lead V1 to V5.UCG showed systolic pulmonary artery pressure of 77mmHg,enlargement of right heart,tricuspid regurgitation velocity of 4.12m/s,and widening of main pulmonary artery and branches.Pulmonary CTA showed multiple pulmonary embolisms involving bilateral pulmonary branches.Lower extremity venous ultrasound showed thrombosis in the right common femoral vein,bilateral posterior tibial vein and intermuscular vein of the leg.Diagnosis of acute pulmonary thromboembolism,lower extremity deep vein thrombosis,adenomyosis,etc.Anticoagulant therapy was given after implantation of inferior vena cava filter and uterine segmentation.A total of 7 literatures containing case data were retrieved,including 1 in Chinese and 6 in English,involving 16 cases.Conclusions:Adenomyosis with venous thromboembolism is not common clinically and treatment is contradictory.In addition,adenomyosis may be a risk factor for venous thromboembolism.
作者
黄艳
商鸣宇
叶晓芳
朱光发
HUANG Yan;SHANG Ming Yu;YE Xiaofang;ZHU Guangfa(Department of Respiratory and Critical Care Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Disease,Beijing,100029,China)
出处
《心肺血管病杂志》
CAS
2023年第1期31-36,共6页
Journal of Cardiovascular and Pulmonary Diseases
