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目的 探讨羊水栓塞的高危因素、临床表现、诊断和治疗方法。方法 分析 3例病人的临床资料。结果 例 1:孕 35 + 1周 ,早产住院 ,宫缩过强 ,突发抽搐 ,血压骤降为零 ,5min内死亡 ,右心室穿刺证实羊水栓塞。例 2 :孕 4 0 + 1周 ,人工破膜 ,30min后突发呛咳 ,呼吸困难 ,进行性紫绀 ,血压下降为 5 0 / 0mmHg ,立即剖宫取胎 ,术中见 :盆腔静脉广泛栓塞 ,发病 35min病人死亡。例 3:催产素引产突发抽搐、紫绀 ,急产一男婴 ,因重度窒息死亡 ,产后出血不凝 ,立刻行子宫全切 ,对症抢救成功。结论 产前发生羊水栓塞 ,死亡率极高 ,宫缩过强是主要原因 ,宜及早采取措施 ,预防羊水栓塞的发生。一旦发生应采取积极有效的治疗措施。
Objective To investigate the risk factors, clinical manifestations, diagnosis and treatment of amniotic fluid embolism. Methods The clinical data of 3 patients were analyzed. Results Example 1: 35 weeks pregnant, hospitalized premature birth, uterine contractions, sudden convulsions, sudden drop in blood pressure to zero, died within 5min, confirmed by amniocentesis of right ventricular puncture. Example 2: pregnancy 40 + 1 week, artificial rupture of membranes, 30 minutes after the sudden cough, difficulty breathing, progressive cyanosis, blood pressure decreased to 50 / 0mmHg, immediate cesarean section fetus, intraoperative see: pelvic vein embolization , The incidence of 35min patients died. Example 3: oxytocin induced abortion convulsions, cyanosis, urgent delivery of a baby boy, died of severe asphyxia, postpartum hemorrhage is not condensate, the uterus is cut completely, symptomatic rescue success. Conclusion Amniotic fluid embolism occurred prenatal mortality rate is extremely high, the main reason for contractions too strong, should take early measures to prevent the occurrence of amniotic fluid embolism. In the event of a positive and effective treatment should be taken.