产科联合ICU救治232例危重孕产妇的资料分析

目的 为探讨入住重症监护病房(ICU)孕产妇的临床特点及母儿预后.方法 对ICU的孕产妇的临床资料进行回顾性分析.根据入住ICU原因不同分为产科原因组及非产科原因组,比较两组间一般临床资料和母儿预后的差别.结果 232例患者正规产检的仅占34.5％.院内死亡7例.入住ICU的孕产妇疾病前3位的是:①妊娠期高血压疾病及相关并发症;②妊娠合并心脏病;③产后即时出血.232例产科患者中,产科原因组131例,占56.5％;非产科原因组101例,占43.5％.产科原因组的平均孕周明显小于非产科原因组(P ＜0.001).产科原因组的平均产后24 h出血量、子宫切除率、失血性休克发生率均明显高于非产科原因组(P＜0.001).结论 为提高对危重孕产妇的诊治能力,产科医师需进一步加强重症监护的知识学习.建立专门的产科ICU,由同时具备产科及ICU知识的医师管理此类患者,必将是未来的一个发展趋势.

Data analysis on 232 cases of critically ill pregnant women cured by combination of the department of obstetrics and ICU

Objective To explore the clinical characteristics and outcomes of obstetric patients in intensive care unit(ICU).Retrospective study over a period of four years and 232 cases were included.Methods Records were reviewed for clinical characteristics,maternal and neonatal outcomes.All patients were divided into obstetric related disease group and non-obstetric related disease group.Results The patients who had regular antienated examination only accounted for 34.5％.Seven patients died.Hypertensive disorders,heart disease and hemorrhage are the main cases of admission.Among the 232 obstetric patients,there are 131 cases(56.5％) in the obstetric group,101 cases(43.5％) in the non-obstetrical group.The average age of the patients in obstetric related disease group were lower than those in non-obstetric related disease group (P ＜ 0.001).The postpartum hemorrahge within 24 hours,the rates of hystereyomy and the rates of hemorrhagic shock in obstetric related disease group were all higher than those in non-obstetric related disease group (P ＜ 0.001).Conclusion The establishment of specialized obstetric ICU and physicians with obstetric and ICU knowledge to manage such patients will be a future development trend.