87例危重症孕产妇ICU救治临床分析

Clinical analysis of 87 cases of ICU treatment in critically ill pregnant women

目的分析探讨危重症孕产妇的临床特点、入住ICU的主要高危因素、ICU脏器监护治疗及干预措施。方法选取2012年5月至2015年12月于福建医科大学附属龙岩第一医院重症医学科ICU病房收治的87例危重症孕产妇,作为研究对象,分析患者病因构成及入住ICU脏器功能影响,产后大出血的出血原因构成及手术治疗情况,入住ICU治疗救治情况以及治疗结局及死亡。结果危重症孕产妇年龄与同期孕产妇相比较有极显著差异,急危重症孕产妇病因构成有基础疾病和产科并发症,产科并发症占82.7%;产后大出血占55.2%,其中凝血异常占43.7%;ICU救治特点产后出血组外院转入病人更多,乳酸水平及APACHE评分更高,治愈81例,治愈率为93.1%。死亡4例,均死于后期并发MODS。结论分析危重症孕产妇年龄、发生的病因及主要高危因素、器官功能影响等相关因素及ICU的救治特点,有利于危重症孕产妇的早期识别,及时转入ICU进行综合救治,提高危重症孕产妇的救治成功率,保证孕产妇的生命安全。

Objective To analyze the clinical features of critically ill pregnant women,the main risk factors of ICU,ICU organ monitoring and intervention measures. Methods 87 cases of critically ill pregnant women from May,2012 to December,2015 year admitted to the ICU ward of the First Affiliated Hospital of Fujian Medical University,were treated as the research object,analyzed the causes and effects on organ function of the patients,postpartum hemorrhage and the hemorrhage surgery treatment,treatment in ICU treatment and the treatment outcome and death. Results There were significant differences between maternal age and maternal age in critical illness,the causes of acute and severe maternal disease were composed of basic diseases and obstetric complications,obstetric complications accounted for 82. 7%; postpartum hemorrhage accounted for 55. 2%,of which,coagulation abnormalities accounted for 43. 7%; ICU treatment features included： in postpartum hemorrhage group,referral patients from outside hospital were more,lactate levels and APACHE scores were higher. 81 cases were cured,the cure rate was 93. 1%. 4 cases died,died of late complication of MODS.Conclusions Analysis of related factors of treatment of critically ill pregnant women age,and the main risk factors,the etiology of organ function and effect of ICU,Is conducive to the early identification of critically ill pregnant women,and to timely transfer to ICU for comprehensive treatment,which will improve the treatment success rate of critically ill pregnant women,and ensure the safety of pregnant women＇s lives.