Safe administration of intrapleural alteplase during pregnancy
Safe administration of intrapleural alteplase during pregnancy
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DOI：
10.21037/jtd.2017.07.114
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发表时间：
2017-09-01
影响因子：
2.5
通讯作者：
Choi, Humberto
中科院分区：
文献类型：
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作者：
Torbic, Heather;Inaty, Hanine;Choi, Humberto
胸腔内注射纤溶剂已被用于复杂的肺旁胸腔积液患者，以改善液体引流，减少手术干预的需要。然而，临床试验没有包括某些特殊人群，如孕妇，目前没有发表的病例报告，这种做法在这一组。我们描述了一个35岁的女性，妊娠32周的G2P1，由于流感肺炎合并细菌性肺炎而出现复杂的胸腔积液。她的肺旁胸腔积液经肋间管引流、组织纤溶酶原激活剂（tPA）和全身抗生素治疗成功，对她或她的胎儿没有伤害，使患者免于更多的侵入性手术。这是首次报道的成功的IP tPA管理的一个复杂的肺旁胸腔积液的孕妇患者。
Instillation of intrapleural (IP) fibrinolytics has been used in patients with complicated parapneumonic pleural effusions to improve fluid drainage and decrease the need for surgical intervention. However, clinical trials have not included certain special populations such as pregnant females and there are currently no published case reports of this practice in this group. We describe the case of a 35-yearold female, G2P1 at 32 weeks of gestation, with a complicated pleural effusion due to influenza pneumonia with superimposed bacterial pneumonia. Her parapneumonic pleural effusion was successfully treated with intercostal tube drainage and IP alteplase [tissue plasminogen activator (tPA)] administration and systemic antibiotics with no harm to her or her fetus, sparing this patient from more invasive surgical procedures. This is the first reported case of successful IP tPA administration for a complicated parapneumonic pleural effusion in a pregnant patient.