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目的探讨提高基层医院羊水栓塞(AFE)诊治水平的方法。方法对广东省吴川市妇幼保健院1995年1月至2004年12月AFE临床资料分前后5年两个阶段进行回顾性分析,并将第二阶段足月分娩AFE救治病例与同期广州医学院附属荔湾医院病例进行对比分析。结果吴川市妇幼保健院10年间足月分娩AFE13例,发生率为5.9/万(13/22013),其中第一阶段AFE10例,发生率10.0/万(10/10015),10例中抢救成功8例,2例死亡;第二阶段AFE3例,发生率2.5/万(3/11998),3例均抢救成功。两阶段AFE发生率比较差异有显著性意义(P<0.05),抢救成功率比较差异无显著性意义(P>0.05)。第二阶段广州医学院荔湾医院足月分娩AFE1例,发生率2.6/万(1/3888),经及时抢救成功,与吴川市妇幼保健院第二阶段足月分娩AFE发生率和抢救成功率比较,差异均无显著性意义(P>0.05)。结论AFE早发现、早治疗,及时去除病因,可达到降低发病率和提高抢救成功率的目的。
Objective To explore ways to improve the diagnosis and treatment of amniotic fluid embolism (AFE) in primary hospitals. Methods The clinical data of AFE from January 1995 to December 2004 in Wuchuan Mochi Hospital of Guangdong Province were retrospectively analyzed in two stages before and after 5 years. The second phase full-term AFE treatment was compared with that of Guangzhou Medical College Liwan Hospital comparative analysis of cases. Results In Wuchuan MCH, 13 cases of full-term delivery of AFE occurred in 10 years, the incidence was 5.9 / (13/22013), of which 10 cases were in AFE in the first phase, the incidence was 10.0 / 10000 (10/10015) Cases, 2 died; the second phase of AFE 3 cases, the incidence of 2.5 / million (3 / 11,998), 3 patients were successfully rescued. There was significant difference in the incidence of AFE in two stages (P <0.05), and there was no significant difference in the success rate of rescue (P> 0.05). In the second stage, 1 case of full-term delivery of AFE was performed in Liwan Hospital of Guangzhou Medical College with an incidence of 2.6 / 10000 (1/3888). After timely rescue, AFE rate and rescue success rate of full-term delivery in the second stage of Wuchuan MCH were compared , There was no significant difference (P> 0.05). Conclusion AFE early detection, early treatment, and timely removal of the cause, can reduce the incidence and improve the success rate of rescue purposes.