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首页 > 医学词汇大全 > amniotic fluid embolism
amniotic fluid embolism

妇产

关键词妇产 疾病 分娩并发症

词汇介绍

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解析

amniotic 英 [æmnɪ'ɒtɪk] 美 [,æmnɪ'otɪk]

释    义   adj. [昆]羊膜的

例    句   Perhaps we are really talking about amniotic fluid, which surrounds the foetus in the birth sac.也许我们真正在谈论的是羊水,也就是包围着胎儿的那些液体。

 

fluid 英 [ˈflu:ɪd] 美 [ˈfluːɪd]

释    义   n. 流体,液体

adj. 流动的;不固定的,易变的;流畅的 [复数 fluids ]

例    句   And what is one own fluid element?什么是一个自己的流体元素?

 

embolism 英 [ˈembəlɪzəm] 美 [ˈembəlɪzəm]

释    义   n. 栓塞;闰日 [复数 embolisms ]

例    句   Treatment of embolism depends on which type it is, how big it is and where it is.栓塞的治疗取决于栓塞的类型、大小和位置。

概述

羊水栓塞(amniotic fluid embolism , AFE)是指羊水进人母体血液循环,引起肺动脉高压、低血症、循环衰竭、弥散性血管内凝血以及多器官功能衰竭等一系列病理生理变化的过程。其临床特点是起病急骤、病情凶险、难以预测、病死率高,是一种极其严重的分娩并发症。近年来,由于各医学学科的发展及支持治疗能力的提高,AFE孕产妇的死亡率已有明显的下降。 病因高龄初产、经产妇、宫颈裂伤、子宫破裂、羊水过多、多胎娃振、子宫收缩过强、急产、胎膜早破、前置胎盘、子宫破裂,剖宫产和刮宫术

Amniotic fluid embolism:principles of early clinical management复制标题

羊水栓塞: 早期临床处理原则

发表时间:2019-07-31

影响因子:6.1

作者: Luis D. Pacheco

期刊:Am. J. Obstet. Gynecol

Amniotic fluid embolism is an uncommon, but potentially lethal, complication of pregnancy. Because amniotic fluid embolism usually is seen with cardiac arrest, the initial immediate response should be to provide high-quality cardiopulmonary resuscitation. We describe key features of initial treatment of patients with amniotic fluid embolism. Where available, we recommend performing transthoracic or transesophageal echocardiography as soon as possible because this is an easy and reliable method of identifying a failing right ventricle. If such failure is identified, treatment that is tailored at improving right ventricular performance should be initiated with the use of inotropic agents and pulmonary vasodilators. Blood pressure support with vasopressors is preferred over fluid infusion in the setting of severe right ventricular compromise. Amniotic fluid embolismerelated coagulopathy should be managed with hemostatic resuscitation with the use of a 1:1:1 ratio of packed red cells, fresh frozen plasma, and platelets (with cryoprecipitate as needed to maintain a serum fibrinogen of >150-200 mg/dL). In cases that require prolonged cardiopulmonary resuscitation or, after arrest, severe ventricular dysfunction refractory to medical management, consideration for venoarterial extracorporeal membrane oxygenation should be given.

译文

羊水栓塞是一种罕见但可能致命的妊娠并发症。由于羊水栓塞通常伴随着心脏骤停,最初的即时反应应该是提供高质量的心肺复苏。我们描述了羊水栓塞患者初始治疗的主要特点。在可行的情况下,我们建议尽快进行经胸或经食道超声心动图检查,因为这是识别右心室衰竭的一种简单可靠的方法。如果确定了这种失败,应使用肌力药物和肺血管扩张剂开始针对改善右心室功能的治疗。在严重右心室损害的情况下,与液体输注相比,使用血管加压剂支持血压更为可取。羊水栓塞相关凝血病应采用1:1:1比例的红细胞、新鲜冰冻血浆和血小板进行止血复苏(根据需要使用冷沉淀以保持血清纤维蛋白原>150-200 mg/dL)。如果需要长时间心肺复苏,或停搏后出现严重的不利于医疗管理的心功能不全,应考虑进行体外膜肺氧合。