羊水栓塞9例临床分析

Clinical analysis of 9 cases of amniotic fluid embolism

目的：分析9例羊水栓塞的诱发因素及临床诊断、处理。方法：收集1990年1月-2005年12月间在北京大兴区人民医院及大兴区妇幼保健院分娩的孕产妇发生的9例羊水栓塞进行回顾性分析。结果：文中发病的9例患者，均有诱因存在。4例死亡，5例救治成功，死亡率44．44％。以胸闷、憋气、呼吸困难、突发呼吸心跳骤停起病的病例抢救成功率低，以阴道出血为主要表现的迟发性的病例，抢救成功率高。文中抢救成功的病例，3例均及时行子宫全切手术。结论：羊水栓塞抢救成功的关键是早诊断、早治疗，最快速度建立呼吸通路，多条循环通路，组成多科室参与的抢救小组，及早行全子宫切除术。

Objective： To analyse the inducement factors, clinical diagnosis and treatment of 9 patients with amniotic fluid embolism. Methods： The backward analysis of 9 patients with occurred amniotic fluid embolism were conducted. All these patients were from Daxing District People＇s Hospital or Daxing Maternal ＆ Child Health Hospital between October 1990 and December 2005. Results： All the 9 patients had inducement factors, 4 of them died, 5 of them saved successfully. The mortality rate was 44. 44%. The patients who feh squeezed or suffocated, then occurred sudden stop of respiration and heartbeat had low successful save rate, while the patients appeared vaginal bleeding firstly had high successfully save rate. Among the 5 survivals, 3 patients did the operation of hysterectomy. Conclusion： Early diagnosis and treatment is the key to save the patients with amniotic fluid embolism successfully. It needs to build an air way and several circulation roads immediately, also need an emergency team with many apartments take part in. At the same time, to do the operation of hysterectomy on time is very important too.