羊水栓塞23例临床分析

目的:通过对23例羊水栓塞(AFE)临床分析,找出其诱发高危因素,并提出防治措施。方法:对我院1988年至2005年中发生的23例AFE的临床资料进行回顾性分析,按每6年为1个阶段划分为3个阶段。结果:18年间AFE的发生率1/1694。催产素使用不当,人工剥膜是AFE的主要诱发因素。23例中18例有产时干预占78.3%,存活13例中,12例及早诊断(92.3%),6例使用肝素(46.2%)。结论:早期诊断,迟早使用肝素,可提高抢救的成功率;加强产时保健、保护、支持、促进自然分娩,减少不必要的医疗干预,是预防AFE发生的有效措施。

The Clinical Analysis of 23 Cases with Ammiotic Fluid Embolism

Objective: To analyze the clinical course of amniotic fluid embolism(AFE)and identify the high risk factors.Method: Twenty-three cases diagnosed as AFE during period of past 18 years were analyzed retrospectively.Eighteen years were divided into 3 stages with 6 years each.Results: The incidence of AFE is 1/1694.Unreasonable use of oxytocics and the man-made pellicle are main element leads to the apperance of AFE.There are 18 cases(78.3%) that would be intervention of during labor among 23 cases.Of 13 Living cases,12 cases(92.3%) were confirmed immediately,and 6 cases(46.2%) were treated with heparin.Conclusion: Forepart diagnoses and using of heparin as early as possible can enhance the possibility of successful salvage,there are some useful methods to avoid the appearance of AFE,including strengthening health care and protection during daring labor,encouraging the promotion of natural delivery,and diminishing unnecessary iatro-intervention.