吕婧 田瑞华 李秋云

[摘要] 目的 总结和探讨在自然分娩产程过程中发生羊水栓塞的早期识别和抢救配合的护理要点。方法 采用回顾性分析的方法对该院2014年1月—2017年12月收治的3例在自然分娩过程中发羊水栓塞病例的临床资料进行收集，观察归纳羊水栓塞的早期临床表现、总结抢救措施和护理干预的方法及效果。 结果 通过准确识别羊水栓塞的前驱症状、积极的抢救治疗、密切的护理配合，无一例孕产妇及新生儿死亡，母婴痊愈出院。 结论 熟练掌握急救流程可以大幅提高抢救成功率，对围生期高危患者提高预警意识、对发生羊水栓塞患者快速精准的识别诊断可以避免延误救治的时机，同样是抢救成功的关键。

[关键词] 羊水栓塞；早期识别；护理

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）08（a）-0139-03

Early Identification and Emergency Care of Amniotic Fluid Embolism During Labor Process

LYU Jing， TIAN Rui-hua， LI Qiu-yun

Beijing You'an Hospital， Capital Medical University， Beijing， 100069 China

[Abstract] Objective To summarize and discuss the nursing points of the early identification and salvage of amniotic fluid embolism during the natural delivery process. Methods The clinical data of amniotic fluid embolism cases during natural delivery were collected from 3 cases from January 2014 to December 2017 in the hospital by retrospective analysis. The early clinical manifestations of amniotic fluid embolism were summarized， rescue measures and nursing interventions were summarized. Results By accurately identifying the prodromal symptoms of amniotic fluid embolism， active rescue treatment， and close nursing care， no cases of maternal and neonatal death occurred， and the mother and child were cured and discharged. Conclusion Proficiency in the emergency procedure can significantly increase the success rate of rescue， raise the awareness of early warning for high-risk patients in the perinatal period， and quickly and accurately identify and diagnose patients with amniotic fluid embolism can avoid the delay of treatment， which is also the key to successful rescue.

[Key words] Amniotic fluid embolism； Early identification； Nursing

羊水栓塞（amniotic fluid embolism，AFE）是指在分娩過程中羊水突然进入母体血液循环引起急性肺栓塞、过敏性休克、弥散性血管内凝血（DIC），肾衰竭等一系列病理改变的严重分娩并发症，其死亡率高达60%以上，是孕产妇死亡的主要原因之一[1]。羊水栓塞通常起病突然，预见性差，临床表现复杂，且病情进展急骤，给产科急救带来一定的困难。但是随着该病认识的不断增加，很多临床经验指出根据患者早期症状及时、准确的识别诊断是抢救羊水栓塞至关重要的环节，可以大幅提高救治的成功率。把该院2014年1月—2017年12月收治的3例发生在自然分娩过程中羊水栓塞的病例进行总结，现报道如下。……