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目的探讨微剂量肝素在羊水栓塞患者中的合理应用及临床治疗价值。方法对2006年1月至2012年12月在湖南省妇幼保健院发生的7例羊水栓塞患者,在诊断为羊水栓塞后予抗过敏、解除肺动脉高压、抗休克、补充凝血因子等对症治疗,同时静脉滴注微剂量的肝素6.25～25 mg。观察治疗前后的血小板(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)等指标的变化;观察阴道流血量。结果 7例羊水栓塞患者均抢救成功,仅1例切除子宫;微剂量肝素治疗后7例患者凝血功能较治疗前明显改善,有效率为100%;肝素使用后未出现严重出血倾向患者。结论微剂量肝素是治疗羊水栓塞的有效方法,具有良好的安全性。
Objective To investigate the rational use of micro-dose heparin in patients with amniotic fluid embolism and its clinical value. Methods From January 2006 to December 2012, 7 cases of amniotic fluid embolism occurred in MCH hospital of Hunan Province were treated with symptomatic treatment of amniotic fluid embolism after anti-allergy, relieve pulmonary hypertension, anti-shock, and clotting factor supplement Intravenous infusion of a small dose of heparin 6.25 ~ 25 mg. The changes of PLT, PT, APTT, FIB and DD were observed before and after treatment. The changes of vaginal bleeding the amount. Results Seven patients with amniotic fluid embolism were successfully rescued. Only one patient underwent uterine resection. The coagulation function of seven patients was significantly improved after treatment with micro-dose of heparin, with an effective rate of 100%. Heparin did not show any serious bleeding tendency after treatment. Conclusion Micro-dose heparin is an effective treatment for amniotic fluid embolism, with good safety.