妊娠中晚期甲型H1N1流感病毒重症及危重症感染作为急诊剖宫产指征的必要性.pdfVIP

2010 8 26 8 627 : 1005- 2216( 2010) 08- 0627- 03 H1 1 乔 宠, 毛明焕,赵 佼, 刘彩霞, 张志涛, 刘 晴,李秋玲, 陈 静 : 研究妊娠中晚期甲型 H1 1流感病 重症和危重症感染是否可以作为急诊剖宫产指征及其必要性 回顾性分析 2009年 11月 8~ 25日于中国医科大学附属盛京医院确诊为甲型H 1 1流感病 重症和危重 症感染的 7例妊娠中晚期妇女的产科处理和新生儿结局,比较剖宫产术前及术后 24h内指脉血氧饱和度动脉血 气分析氧分压氧合指数的变化 7例妊娠中晚期孕妇除 1例为重症, 发生急性肺损伤, 未行呼吸机辅助 呼吸外, 余 6例均为危重症,均发生急性呼吸窘迫综合征, 均进入 ICU 并采用机械通气辅助呼吸7例患者均采 用剖宫产或剖宫取胎术结束妊娠, 4例新生儿存活(其中2例胎儿窘迫), 3例胎死宫内取出胎儿后5min指脉血 氧饱和度立即由术前 07086 00955显著增加至08014 02019(P 0. 01)术后 1h指脉血氧饱和度无明显 改变 (P 0. 05)术后 12~ 24h动脉血氧分压则显著高于术前, 达到( 90. 27 19. 91) mmHg(P 005) 术后 12~ 24h氧合指数则显著高于术前和术后 1h,达到 155. 57 116. 06(P 0. 05,P 0. 05)4例存活的新生儿均无 窒息, 预后良好 妊娠中晚期甲型 H 1 1流感病 重症和危重症感染应作为急诊剖宫产指征, 及时终止妊 娠以缓解及改善病情,而不必拘泥于是否有产科指征 : 妊娠中晚期; 甲型 H 1 1流感病 重症和危重症感染;剖宫产 The importance of severe and criticalH1N1 influenza virus infection in the second and third trimesterpregnancy as an indication of emergency caesarean section. QIAO Chong, MAO M inghuan, ZHAO Jiao, LIU Caixia, ZHANG Zhitao, LIU Qing, LI Qiuling, CHEN Jing. D ep art ent of Obstetrics Gynecology, Shengjing H osp ital, ChinaM edical University, Shenyang 110004, China Abstract: Objective To investigate severe and criticalH 1 1 influenza virus infection in the second and third trmi ester pregnancy as an indication of emergency cesarean section and its mi portance. M ethods W e performed a retrospective study on seven pregnantwomenwith severe and criticalH 1 1 influenza virus infection in ShengjingHospital, ChinaM ed icalUniversity, from ov 8, 2009 to ov 25, 2009. To study the obstetricalmanagement and neonatal outcomes, and compared the variation of the arterialoxygen saturation, the arterialpressure ofo