论文部分内容阅读
患者33岁,孕5产1,孕5月胎动消失6天,于1990年3月7日入院。末次月经1989年9月27日。产前检查正常,孕早期无阴道流血,3月1日胎动消失。3月5日“B”超提示死胎。曾自然流产3次,早产1次,无成活新生儿。否认高血压、心脏病、肾脏病史。查体:血压14.6/9.3kPa,心肺正常,肝脾不大,双下肢无浮肿,宫高20cm,未听到胎心。诊断:孕23~+周,死胎。肝肾功正常,三P试验阴性,凝血酶原19.5秒,纤维蛋白原0.17g,血小板8×10~9/L。考虑死胎有DIC高危因素,给予静脉滴注低分子右旋糖酐、肝素、潘生丁后于3月10日行静滴催产素引产,血压为14/9kPa,病人无不适。晚上呕吐一次后约20分钟突然抽搐、牙关紧闭,给予吸氧、肌注鲁米那、25%硫酸镁静滴,血压20/12kPa,抽搐约2分钟后停止。凌晨出现
33-year-old patient, pregnant and 5 births 1, fetal mothers disappeared in May 6 days, on March 7, 1990 admission. The last menstruation September 27, 1989. Prenatal examination was normal, no vaginal bleeding in early pregnancy, fetal movement disappeared on March 1. March 5, “B” super-prompt stillbirth. Had spontaneous abortion 3 times, 1 premature birth, no survival of newborns. Denied high blood pressure, heart disease, kidney disease history. Physical examination: blood pressure 14.6 / 9.3kPa, normal heart and lungs, liver and spleen is not large, no swelling of the lower extremities, Palace height 20cm, did not hear the fetal heart rate. Diagnosis: Pregnancy 23 ~ + weeks, stillbirth. Normal liver and kidney function, three P test was negative, prothrombin 19.5 seconds, fibrinogen 0.17g, platelets 8 × 10 ~ 9 / L. Taking into account the high risk factors for stillbirth with DIC, intravenous infusion of low molecular weight dextran, heparin, dipyridamole after March 10 intravenous infusion of oxytocin, blood pressure 14 / 9kPa, the patient without discomfort. Vomiting at night about 20 minutes after a sudden convulsions, teeth closed, given oxygen, intramuscular injection of luminal, 25% magnesium sulfate intravenous infusion, blood pressure 20 / 12kPa, about 2 minutes after convulsion to stop. Early in the morning