论文部分内容阅读
目的:分析4例羊水栓塞的临床处理,总结认识与体会。方法:1993年~2006年4例羊水栓塞的处理、母儿预后临床资料进行回顾性分析。结果:存活3例,死亡1例,应用肝素2例,总量50mg~100mg。1例发生肺栓塞并发急性呼吸困难应用地塞米松20mg静推,肝素100mg及辅助呼吸,存活,2例在剖宫产术中出现不凝固出血,1例行次全子宫切除存活,另1例未行子宫切除而死亡,均未用地塞米松,1例于出现不凝固出血后给予应用肝素、地塞米松及凝血因子,仍出血不止,而行次全子宫切除术,存活。结论:抢救成功的关键为识别早期症状。较大剂量肾上腺皮质激素可阻断发病环节。肝素的选择性应用,剂量宜小不宜大。快速补充血容量及凝血因子,充分供氧,如需切除子宫应果断行子宫切除以免失去抢救机会,要识别肺功能的变化,必要时给予辅助呼吸。
Objective: To analyze the clinical treatment of 4 cases of amniotic fluid embolism, summarize understanding and experience. Methods: From 1993 to 2006, 4 cases of amniotic fluid embolism were treated and the clinical data of maternal and child prognosis were analyzed retrospectively. Results: Survival in 3 cases, 1 died, heparin in 2 cases, the total amount of 50mg ~ 100mg. 1 case of pulmonary embolism complicated by acute dyspnea dexamethasone 20mg static push, heparin 100mg and assisted breathing, survival in 2 cases of non-coagulation bleeding during cesarean section, 1 case of subtotal hysterectomy survival, the other 1 case No hysterectomy and death, did not use dexamethasone, 1 case of non-coagulation bleeding given to the application of heparin, dexamethasone and clotting factor, still more than bleeding, and underwent hysterectomy and survival. Conclusion: The key to successful salvage is identifying early symptoms. Larger doses of adrenal cortex hormones can block the pathogenesis. Selective application of heparin, the dose should be small should not be large. Quickly add blood volume and clotting factors, adequate oxygen supply, for removal of the uterus should be determined hysterectomy to avoid the chance of rescue, to identify changes in lung function, if necessary, to give auxiliary breathing.