12危重孕产妇急诊剖宫产终止妊娠的危险因素分析.docVIP

危重孕产妇急诊剖宫产终止妊娠的危险因素分析 许国根 徐芝君 章浩 顾清 裘力锋 [摘要]：目的：回顾分析危重孕产妇的临床资料，探讨采取急诊剖宫产终止妊娠患者的危险因素。方法：收集我院急诊收治危重孕产妇187例患者，其中76例急诊剖宫产终止妊娠（急诊剖宫产组），收入专科病房治疗后择期剖宫产111例（择期剖宫产组）。对两组患者一般情况（包括年龄、孕龄、孕次、产次、产前规律产前检查、既往史、居住地），急诊就诊和疾病种类，急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、急诊就诊时的各种检查结果[包括血红蛋白、血清白蛋白、血肌酐（SCr）、凝血酶原时间国际标准化比值（INR）、氧合指数（PaO2/FiO2）等]进行统计学分析。结果：两组患者居住地、产前检查、血红蛋白、血清白蛋白、血肌酐、INR、PaO2/FiO2、HELLP综合症、妊娠急脂肪肝、急性心功能不全、急性呼吸功能不全、急性肾功能不全和SAP比较差异均有统计学意义（P＜0.05）；而年龄、妊娠相关性高血压和APACHEⅡ评分比较差异无统计学意义（P ＞0.05）。结论：通过对危重孕产妇急诊剖宫产终止妊娠的危险因素分析，提出了救治危重孕产妇时，采取急诊剖宫产手术紧急终止妊娠的一些指标和指征，为有效规范救治危重孕产妇提供临床依据。 [关键词] 危重孕产妇 急诊剖宫产 终止妊娠 危险因素 The Analysis of risk factors of election emergency uterine-incision delivery to terminate pregnancy in critical pregnancy patients Xu Guogen, Xu Zhijun, Zhang Hao, Gu Qing, Qiu Lifeng. The first municipal hospital of Hangzhou , Hangzhou Zhejiang 310006 [ABSTRACT］Objective:a retrospective analysis of the clinic records of critical pregnancy?patients ha been performed in order to discuss risk factors of the election emergency uterine-incision delivery to terminate pregnancy. Methods:the clinic records of critical 187 pregnancy?patients appeared to our hospital have been collected.78 of the total accepted emergency uterine-incision delivery(The group of emergency uterine-incision delivery) to terminate pregnancy and the others accepted selective operation(The group of selective uterine-incision delivery) .The records of the two groups have been collected and analysis, including: general state(age, gestational age, gravidity, parity, regular antenatal examination, history and occupation ); underline diseases; scores of APACHEⅡand the results of laboratory examination. Results:The occupation; regular antenatal; levels of haematoglobin, serum albumen, serum creatinine;INR, oxygenation index, HELLP syndrome; acute adiposis hepatica; acute heart failure, acute respiratory failure, acute renal failure and acute severe pancreatitis have been shown to be significant diff