摘要
目的:探讨羊水栓塞导致孕产妇死亡的危险因素。方法:对我院1999年1月～2012年6月羊水栓塞导致孕产妇死亡的病例资料进行回顾性分析。结果:本组患者主要临床表现呼吸困难34例,休克51例,紫绀54例,昏迷抽搐41例,DIC 31例。栓塞诱发因素催产素15例,米索前列醇引产3例,宫颈裂伤5例,羊水混浊13例,胎膜早破15例,外用腹压1例,胎盘早剥3例,急产4例。栓塞至死亡时间<0.5h的为10例,0.5～1h的为19例,>1h的为30例。诊断依据外周静脉血或心血涂片诊断8例,尸检诊断3例,临床诊断38例,以及死后推断为10例。本组中可避免死亡的为1例,创造有利条件可避免产妇死亡的为12例,不可避免死亡46例。其中可避免以及创造条件可避免死亡的为13例(22.03%)。结论:羊水栓塞具有起病急,早期难以诊断,在临床运用中应当重视患者的早期表现,避免滥用催产素等,同时在分娩过程中应当对羊水栓塞进行有效预防,降低羊水栓塞的发生以及致死率。
Objectives： To explore the risk factors for maternal death caused by amniotic fluid embolism. Methods： A ret- rospective analysis was made on the clinical data of pregnant patients who died of amniotic fluid embolism from January 1999 to June 2012 in our hospital. Results： The clinical manifestation of the patients includes difficulty breathing （34 cases） , shock （51 cases）, cyanosis （54 cases）, coma（41 cases）, convulsions （41 cases）, DIC （31 case）. Embolism- induced Oxytocin was ob- served in 15 cases. Three cases had misoprostol induction of labor. We also found 5 cases of cervical laceration, 13 cases of am- niotie fluid turbidity, 15 cases of premature rupture of membranes, one case of abdominal pressure, three cases of placental ab- ruption, and four cases of acute production. The results also indicated. 8 cases diagnosed by peripheral venous blood or effort smear diagnosis, 3 cases diagnosed by the autopsy, 38 cases diagnosed by clinical checkup and 10 cases diagnosed after their death. Conclusion： The amniotic fluid embolism has acute onset and early diagnosis is difficult. Doctors should pay attention to the early manifestation of patients, and should avoid the abusive use of oxytocin. Amniotic fluid embolism during childbirth should be effectively prevented so as to reduce the rate of embolism occurrence and maternal death.
出处
《中国性科学》
2012年第11期30-32,共3页
Chinese Journal of Human Sexuality
关键词
羊水栓塞
死亡
危险因素
Amuiofic fluid embolism
Death
Risk factors
