中国急救医学
中國急救醫學
중국급구의학
CHINESE JOURNAL OF CRITICAL CARE MEDICINE
2014年
8期
711-713
,共3页
孕产妇%失血性休克(HS)%临床特点%急救
孕產婦%失血性休剋(HS)%臨床特點%急救
잉산부%실혈성휴극(HS)%림상특점%급구
Maternity%Obstetrical hemorrhagic shock%Clinical characteristics%First aid
目的：探讨产科失血性休克（hemorrhagic shock， HS）的临床特点及急救方法。方法回顾性分析我院收治的46例产科HS危急重症产妇（试验组）和同期未发生HS的产妇（对照组）胎盘前置、胎盘早剥、胎盘残留或粘连、宫缩乏力、产道裂伤及产后出血等的发生情况，分析HS的主要危险因素，并探讨综合急救措施的救治效果。结果试验组胎盘前置、胎盘残留或粘连、胎盘早剥、宫缩乏力、产道裂伤及凝血机制障碍发生率均明显高于对照组（P＜0．05）；试验组出血量在800～1500 mL和1500～2000 mL HS患者明显低于对照组，当出血量＞2000 mL时，HS患者明显高于对照组（ P＜0．05）；所有46例HS产妇经抢救和治疗后均脱离危险，无一例死亡，抢救成功率为100％。结论胎盘前置、胎盘残留或粘连、胎盘早剥、宫缩乏力、产道裂伤、凝血机制障碍及产后出血等均为诱发产科HS的主要危险因素，及时采取有针对性抢救措施，同时进行并发症预防，能够有效地提高抢救成功率。
目的：探討產科失血性休剋（hemorrhagic shock， HS）的臨床特點及急救方法。方法迴顧性分析我院收治的46例產科HS危急重癥產婦（試驗組）和同期未髮生HS的產婦（對照組）胎盤前置、胎盤早剝、胎盤殘留或粘連、宮縮乏力、產道裂傷及產後齣血等的髮生情況，分析HS的主要危險因素，併探討綜閤急救措施的救治效果。結果試驗組胎盤前置、胎盤殘留或粘連、胎盤早剝、宮縮乏力、產道裂傷及凝血機製障礙髮生率均明顯高于對照組（P＜0．05）；試驗組齣血量在800～1500 mL和1500～2000 mL HS患者明顯低于對照組，噹齣血量＞2000 mL時，HS患者明顯高于對照組（ P＜0．05）；所有46例HS產婦經搶救和治療後均脫離危險，無一例死亡，搶救成功率為100％。結論胎盤前置、胎盤殘留或粘連、胎盤早剝、宮縮乏力、產道裂傷、凝血機製障礙及產後齣血等均為誘髮產科HS的主要危險因素，及時採取有針對性搶救措施，同時進行併髮癥預防，能夠有效地提高搶救成功率。
목적：탐토산과실혈성휴극（hemorrhagic shock， HS）적림상특점급급구방법。방법회고성분석아원수치적46례산과HS위급중증산부（시험조）화동기미발생HS적산부（대조조）태반전치、태반조박、태반잔류혹점련、궁축핍력、산도렬상급산후출혈등적발생정황，분석HS적주요위험인소，병탐토종합급구조시적구치효과。결과시험조태반전치、태반잔류혹점련、태반조박、궁축핍력、산도렬상급응혈궤제장애발생솔균명현고우대조조（P＜0．05）；시험조출혈량재800～1500 mL화1500～2000 mL HS환자명현저우대조조，당출혈량＞2000 mL시，HS환자명현고우대조조（ P＜0．05）；소유46례HS산부경창구화치료후균탈리위험，무일례사망，창구성공솔위100％。결론태반전치、태반잔류혹점련、태반조박、궁축핍력、산도렬상、응혈궤제장애급산후출혈등균위유발산과HS적주요위험인소，급시채취유침대성창구조시，동시진행병발증예방，능구유효지제고창구성공솔。
Objective To investigate the clinical characteristics and first aid of obstetrical hemorrhagic shock .Methods Forty-six patients with obstetrical hemorrhagic shock and other patients without obstetrical hemorrhagic shock were investigated retrospectively .The placenta previa , placental abruption, placenta accreta or placenta remnants , Uterine Atony, laceration of birth canal , coagulation disorder dysfunction , postpartum hemorrhage were analyzed .The main risk factors for hemorrhagic shock were analyzed , and the effect of comprehensive emergency measures were discussed .Results The rate of placenta previa , placental abruption , placenta accreta or placenta remnants , Uterine Atony, laceration of birth canal, coagulation disorder dysfunction were higher than those of the control group (P<0.05). The ratios of bleeding volume ranging in 750~1500 mL or 500~2000 mL were lower in the observed group than those of the control group (P<0.05), but the ratio was higher in the observed group when the patients bleeding volume >2000 mL compared with the control group (P <0.05).All of the patients were out of danger , and the rate of rescue success was 100%.Conclusion The main risk factors for hemorrhagic shock include placenta previa , placental abruption , placenta accreta or placenta remnants, Uterine Atony, laceration of birth canal , coagulation disorder dysfunction , postpartum hemorrhage .It helps to increase the rate of rescue success by effective rescue measures and prevention complications .
