中国实用妇科与产科杂志

中国实用妇科与产科杂志

• 专题笔谈 • 上一篇    下一篇

羊水栓塞团队处置与抗凝治疗——目前的观点

  

  1. 广州医科大学附属第三医院  广州重症孕产妇救治中心,广东 广州  510150
  • 出版日期:2017-07-02 发布日期:2017-07-04
  • 通讯作者: 陈敦金

Team management and anticoagulation treatment for amniotic fluid embolism - the current viewpoint

  1. the Third Affiliated Hospital of Guangzhou Medical University，Guangzhou 510150，China
  • Online:2017-07-02 Published:2017-07-04

摘要：

羊水栓塞（amniotic fluid embolism，AFE）是产科最凶险的并发症之一，常危及孕产妇及胎儿的安全。由于AFE病例少见，虽其病因清晰，但确切发生机制目前仍不清楚。目前临床上在羊水栓塞发生弥漫性血管内凝血（disseminated intravascular coagulation，DIC）时是否应用抗凝剂尚存争议，但由于AFE起病急骤，发展迅速，难以选择最佳应用抗凝剂时间，应用不当反而加重病情，故不推荐常规使用抗凝剂。根据国内外救治经验得出早期识别羊水栓塞、及时启动快速反应团队是救治成功的关键。

关键词: 羊水栓塞, DIC, 抗凝剂, 快速反应团队

Abstract:

Amniotic fluid embolism（AFE）is one of the catastrophic complications of pregnancy，and it is often life-threatening to pregnant women and fetus.Although the cause is clear，but the exact mechanisms of AFE are still unclear.The use of anticoagulant in AFE therapy remains controversial when disseminated intravascular coagulation（DIC）occurs.AFE is often with acute onset and develops rapidly，so it’s hard to select the best time to use anticoagulant，and improper use of anticoagulant may aggravate the disease.So，anticoagulant isn't recommended for routine use in clinics.Based on the treatment experience and lessons of AFE at home and abroad，early recognition and a rapid response team are the key to successful treatment of AFE.

Key words: amniotic fluid embolism, disseminated intravascular coagulation, anticoagulants, rapid response team

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