摘要
目的:分析剖宫产术后发生呼吸窘迫综合征(ARDS)的发病原因及临床特点。方法:回顾性分析2005年1月至2015年12月第三军医大学附属西南医院收治的剖宫产后诊断为ARDS的产妇19例的临床资料。结果:只有6例(31.6%)被诊断为上呼吸道感染或肺炎,其中剖宫产术前有上呼吸道感染或肺炎临床表现的仅3例。剖宫产手术指征为:重度子痫前期10例(合并部分性前置胎盘1例、中央性前置胎盘1例),轻度子痫前期1例,绒毛膜羊膜炎2例,瘢痕子宫合并边缘性前置胎盘1例,羊水过少1例,相对头盆不称2例,妊娠期急性脂肪肝1例,血小板减少合并重度贫血1例。剖宫产后发生ARDS的时间24~56小时2例,术后24小时内发生8例,术中及术后即刻发生9例。需要呼吸机治疗9例(47.4%),所有患者均好转出院。结论:应警惕妊娠期特有加重肺水肿及肺部感染的疾病,严格控制剖宫产手术指征并加强围手术期管理。
Objective：To analyze the causes and the clinical features of acute respiratory distress syndrome （ARDS） after the caesarean section （CS）. Methods：Retrospective analysis was conducted on the 19 cases with ARDS after CS that were treated in Southwest Hospital of Third Military Medical University between January 2005 and December 2015. Results：Only 6 cases（31.6% ） were diagnosed with upper respiratory infection or pneumo- nia,3 of them with clinical symptoms. The indications for CS included 10 severe pre-eclampsia（with 1 partial pla- centa previa,1 central placenta previa） ,1 mild pre-eclampsia,2 chorioamnionitis,1 scar uterus with marginal pla- centa previa, 1 oligohydramnios,2 relative cephalopelvic disproportion, 1 acute fatty liver of pregnancy and 1 thrombocytopenia with severe anmia. The ARDS onset time of 2 cases occurred after 24 -56h of the CS. 8 cases within 24h and 9 cases during CS. 9 cases（47.4%） were treated with ventilator. All of them recovered and dis- charged. Conclusions ：We should be alert for the diseases that can aggravate the pulmonary edema and infec- tions during pregnancy,and the CS indications should be strictly controled.
作者
张文希
严小丽
刘鹤莺
张耀榕
王丹
ZHANG Wenxi,YAN Xiaoli,LIU Heying,et al(SouthwestHospital of Third Military Medical University, Chongqing 400038, Chin)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2018年第3期216-220,共5页
Journal of Practical Obstetrics and Gynecology
关键词
剖宫产术后
呼吸窘迫综合征
肺炎
上呼吸道感染
After caesarean section
Acute respiratory distress syndrome - Pneumonia
Upper respiratory infection
