羊水栓塞救治成功5例的临床研究

A clinic study of 5 cases on the successful treatment of amniotic fluid embolism

目的探讨羊水栓塞(AFE)的有效救治措施。方法回顾性分析我院经治的5例AFE病例,对其临床救治过程进行剖析,总结抢救成功因素。结果剖宫产术中发生的4例急性AFE,采用给氧、大剂量地塞米松、肾上腺素、阿托品、多巴胺等综合急救,全部救治存活。产后以出血为主的1例AFE经纠正DIC、子宫切除后救治存活。结论肾上腺素在救治急性AFE时有使用价值。AFE发生难以纠正的DIC时,切除子宫是重要治疗措施。

Objective ： To explore the effective treatment of amniotic fluid embolism （AFE）. Methods ： The treatment of the five patients with amniotic fluid embolism was analysed retrograde so as to make a summary of the successful factors on therapy. Results： Four patients with amniotic fluid embolism during cesearean section were treated successfully using a combinational measurement of oxygen delivery, large doses of dexamethasone, adrenalin, atropine, dopamine, and etc. One patient with AFE characterized by postpartum hemorrhage was also treated successfully after correction of DIC and hysterectomy. Conclusions ： Adrenalin administration is useful in the treatment of AFE, hysterectomy is an important measurement in AFE patients with DIC refractory to routine therapy.