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目的通过探讨围术期羊水栓塞的发生原因及诊治措施,提高对羊水栓塞的诊断、预防及抢救水平。方法收集1995年5月-2011年8月围术期羊水栓塞患者11例,进行回顾性分析。结果 11例羊水栓塞患者中,进入手术室尚未进行麻醉出现羊水栓塞的患者2例,剖宫产术中出现羊水栓塞的患者9例。有胸闷、呼吸困难、呛咳等肺动脉高压症状者6例,确诊弥散性血管内凝血(DIC)者5例,经抢救治疗后,6例症状缓解,4例切口及阴道出血不止,行子宫全切除或次全切除术。抢救无效死亡1例,抢救治愈10例,死亡率9.09%。结论及时、正确的诊断,并采取合理、有效的抢救措施是提高抢救成功率的关键。
Objective To explore the causes of perioperative amniotic fluid embolism and diagnosis and treatment measures to improve the diagnosis, prevention and rescue of amniotic fluid embolism. Methods 11 cases of perioperative amniotic fluid embolism from May 1995 to August 2011 were retrospectively analyzed. Results Among the 11 cases of amniotic fluid embolism, 2 cases had amniotic fluid embolism without anesthesia in the operating room and 9 cases had amniotic fluid embolism in cesarean section. Six patients with symptoms of pulmonary hypertension, such as chest tightness, dyspnea, cough and cough, and 5 patients with disseminated intravascular coagulation (DIC) were diagnosed. After salvage treatment, 6 patients were relieved of symptoms, 4 were incisional and vaginal bleeding, Resection or subtotal resection. One case of ineffective rescue, 10 cases of rescue and cure, the mortality rate was 9.09%. Conclusion timely and correct diagnosis, and take reasonable and effective rescue measures is to improve the success rate of rescue key.