胎儿娩出前羊水栓塞5例临床分析

发布时间：2019-07-26 12:04

【摘要】：目的:分析胎儿娩出前羊水栓塞(AFE)的临床表现和处理,总结早期诊断和治疗的重要性。方法:对成都市妇女儿童中心医院收治的5例胎儿娩出前发生AFE孕产妇的临床表现、诊断、治疗和母儿预后的临床资料进行回顾性分析。结果:1例猝死患者因突发呼吸心跳骤停,早期诊断困难,未及时行AFE相关治疗,母儿均死亡。4例存活患者,在出现相关早期症状时立即怀疑AFE并迅速开始抗过敏、解除肺动脉高压和剖宫产术,其中2例行心肺复苏,2例行输血等抗休克及纠正凝血功能障碍治疗,3例行子宫切除术,除1例因在家中发生AFE延误病情,围生儿死亡外,其余母儿结局良好。结论:AFE抢救成功的关键为早期诊断,并及时抗过敏和解除肺动脉高压,有效心肺复苏、纠正凝血功能障碍,及早行剖宫产术,必要时行子宫切除术。
[Abstract]:Objective: to analyze the clinical manifestations and management of amniotic fluid embolism (AFE) before delivery, and to summarize the importance of early diagnosis and treatment. Methods: the clinical manifestations, diagnosis, treatment and maternal and infant prognosis of 5 pregnant women with AFE before delivery in Chengdu Women and Children Central Hospital were analyzed retrospectively. Results: one patient with sudden respiratory and cardiac arrest, difficult to diagnose early, did not receive AFE related treatment in time, both mother and child died. 4 survival patients immediately suspected AFE and quickly began antiallergy, relieve pulmonary hypertension and cesarean section in the event of related early symptoms, including 2 cases of cardiopulmonary resuscitation, 2 cases of antishock and correction of coagulation dysfunction, 3 cases of hysterectomy, 2 cases of cardiopulmonary resuscitation, 2 cases of blood transfusion, 3 cases of hysterectomy, 2 cases of cardiopulmonary resuscitation, 2 cases of antishock and correction of coagulation dysfunction, 3 cases of hysterectomy, 2 cases of cardiopulmonary resuscitation, 2 cases of blood transfusion, 3 cases of hysterectomy. Except for one case of delayed AFE at home and the death of parturients, the rest of the mothers and children ended well. Conclusion: the key to the successful rescue of AFE is early diagnosis, timely anti-allergy and release of pulmonary hypertension, effective cardiopulmonary resuscitation, correction of coagulation dysfunction, early cesarean section and hysterectomy if necessary.
【作者单位】：成都市妇女儿童中心医院;四川大学华西第二医院出生缺陷与相关妇儿疾病教育部重点实验室;
【基金】：四川省卫生计生委重点研究项目(编号:16ZD017)
【分类号】：R714.468

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