牛牛游戏厅安卓,{原始关键词}

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                            1. 当前位置: 代写一篇论文多少钱 > 医学论文 > 急性羊水栓塞产妇的抢救心得

                              急性羊水栓塞产妇的抢救心得

                              时间:2019-01-17 10:28作者:于淼淼
                              本文导读:这是一篇关于急性羊水栓塞产妇的抢救心得的文章,羊水栓塞对于产妇及胎儿来说都有十分严重的影响,在无法保胎的情况下,为了确保母体的健康,必须及时有效地进行相关护理干预,以促进治疗工作的顺利开展,提高患者存活率。

                                摘    要: 羊水栓塞(AFE)是一种产科严重的因分娩导致的并发症。其临床通常表现为急性肺栓塞、过敏性休克、突发性低血压、肾衰竭或猝死、低氧血症、DIC等。发病时期可为足月妊娠,但妊娠早、中期流产亦可发生。

                                关键词: 羊水栓塞; 分娩; 急救处理; 护理体会;

                                YANJIUZHICHU,YANGSHUISHUANSAIQIBINGBIJIAOJI,JIBINGDEFAZHANSUDUXUNSU,DADUOSHUHUANZHEYINZAOQIWUDIANXINGZHENGZHUANGERBEIHULVE,CUOGUOZUIJIAQIANGJIUDESHIJIAN,ZUIZHONGDAOZHIHUANZHESIWANG。YANGSHUISHUANSAIDEDIANXINGZHENGZHUANGSUIRANBIJIAODUO,RUDIXUEYANG、NINGXUEGONGNENGZHANGAIJITUFAXINGDIXUEYADENG,DANSHIYINHUANZHEDEGERENTIZHIBUTONG,ZAILINCHUANGBIAOXIANZHONGYEGEBUXIANGTONG。

                                1、 病例资料

                                HUANZHE,NV,32SUI,ZAI2018NIAN10YUE26RIZAOSHANG8:30FENYIN“XIANZHAOLINCHAN”ERRUYUAN,YU9:15JINRUCHANFANG,HUANZHE9:50SHITUFAXINGJINGJIAO,JIEZHESANGSHIYISHI,XINTIAOZHOUTINGQIEHUXIXIAOSHI。YIHURENYUANJIKEZUOXINFEIFUSUCHULI,TONGSHIJIYU10mgDISAIMISONG、1mgSHENSHANGXIANSUPEIHEJINGMAITUIZHU。9:57HUANZHEZHUJIANHUIFUXINTIAOJIZIZHUHUXI,DANSHENQINGDANMO,JINGCHATIXIANSHITAIXINYINXIAOSHI,WEIJIXINGYANGSHUISHUANSAIKENENG,TAISIFUZHONG。LIKEKAOLVXINGPOUGONGCHAN,RUSHISHIHUANZHEYISHIZAICISANGSHI,JINGXINDIANJIANHUXIANSHI,HUXI35CI/min,JICU,HP160min,BP45/25mmHg,SPO2WEI60%。DUIHUANZHELIKEYONGMIANZHAOJIAYAXIYANG,JIYUDISAIMISONGHEMAHUANGSUJINGTUI,JIYUDUOBAANHESHENSHANGXIANSUJINGDI,JIEZHEZAI12mgYITUOMIZHIHE80mgSIKELINDEYOUDAOXIAXINGQIGUANCHAGUANQUANMA。

                                SHOUSHUKAIFUSHIHUANZHECHUXUELIANGDA,ZIGONGJITAIMOPOLIE,ERTAIERZEYOULICHUZIGONGWAI,JIANGTAIERQUCHU,CHATIWUHUXIJIXINTIAO,JINXINGXINFEIFUSUYIWUXIAO,TAIERZHONG5kg。DUICHANFUYONGWANKESONG、YIFUMIDENGWEICHIMAZUI,KEJIANSHUZHONGJINGMAICHUANCICHU、QIEKOUJIZIGONGYOUYANZHONGSHENXUEQINGKUANG,XUEYEWUFANINGJIE,YONGDALIANGNINGXUEYAOWUXIAO,CAIQUZIGONGDONGMAIHEQIANEIDONGMAIDENGJIEZHASHUWUXIAOHOU,JINXINGZIGONGQIECHU。SHOUSHUSHIJIANYUE9h,CHANFUSHUZHONGCHUXUELIANGWEI8000mlZUOYOU,XUEJIANGSHUZHU3000mlZUOYOU,LINGJIYU30UHONGXIBAOHE7000mlYETISHUZHU。SHUZHONGHUANZHECHIXUDIXUEYAZHENGZHUANGYUE7h,QIBPZEYUEWEICHIWEI80/55mmHg,CAIQUSHENGYAYAOHESHUXUEKUORONGZHILIAOBUMINGXIAN。QUANMAHOUFENXIXUEQIZHIBIAO,YANGHEZHISHUWEI163,pHWEI7.15,BEWEI14mmol/L,JIYU30mgQINGHUAKEDESONG、40mgFUSAIMIHE5%TANSUANQINGNA400mlJINXINGKANGGUOMINZHILIAO,BINGJIJIJIUZHENGSUANZHONGDUJIYUFANGSHENSHUAIZHENGZHUANG。

                                JIESHUSHOUSHUHOUJINGXINDIANJIANHUKEJIANHRWEI120CI/min,BPWEI120/65min,SPO2WEI90%,HUANZHEQINGXINGHOUJIANGQIGUANDAOGUANBACHUTUISONGZHIBINGFANGXIUYANG。HUANZHEYU2018NIAN11YUE3RIQUANYUCHUYUAN。

                                2、 讨论

                                对于羊水栓塞,当前临床尚未明确其发病机制,多数学者认为是在羊水进入到血循环之后,对肺小血管产生阻塞作用,引发肺动脉高压、凝血功能异常及Ⅰ型变态反应等,导致产妇机体出现病理性的生理变化,最终形成羊水栓塞[1][2]。临床对其诊断主要根据患者临床分期表现,在分娩期间或者分娩后都有可能发生,以“三联症”为典型症状,即低氧、低血压及凝血功能异常,也是对羊水栓塞诊断的主要标准,但实际上该机制尚无完整说法。如患者对围产期产妇是否存在急性循环衰竭、呼吸困难、神志异常、低氧血症及弥散性血管凝血等表现,若存在任何两种或以上表现,当排除其他因素后,可考虑为羊水栓塞。
                               

                              急性羊水栓塞产妇的抢救心得
                               

                              牛牛游戏厅安卓,{原始关键词}   LINCHUANGZAIZHILIAOYANGSHUISHUANSAISHI,YINGYIKUAISUQUEZHENHEKUAISUQIANGJIUWEIYUANZE,MUDESHIWEILEWANJIUCHANFUDESHENGMING,JUTIWEI:(1)DANGCHANFUFASHENGXINZANGZHOUTINGHUOZHEXINTIAOXIAOSHISHI,LIKEJIYUXINFEIFUSUCHULI。DUIWEIMIANCHUTAIERZHE,ZAI5minNEIJINKUAITONGGUORENGONGFUZHUJIANGTAIERMIANCHU。(2)CHANFUYOUHUXIKUNNANHUOZHEDIYANGXUEZHENGSHI,XUQUEBAOQIDAODETONGCHANGJIMIANZHAOXIYANG,BIYAOSHIKESHIYONGHUXIJIFUZHUTONGQI,BINGJISHIWANSHANZHILIAOCUOSHI。(3)CHANFUZAIXUNHUANXITONGSHOUXIANERFASHENGDIXUEYASHI,YINGKUAISUJIANLIQIXIANGYINGDEJINGMAITONGDAO,LIUZHIZHONGXINJINGMAIDAOGUAN,BINGGENJUCHANFUQINGKUANGJIYUSHIDANGDEXUEGUANHUOXINGYAO,ZAIYETIFUSUSHI,MUBIAOSHEDINGWEINIAOLIANG≥0.5ml(kg·h),SHOUSUOYA≥90mmHg,YANGFENYA≥60mmHg,FUSURONGLIANGJISHENGYAYAOKEZAISHIDAOCHAOSHENGXINDONGTUDEZHIDAOXIAHELIYINGYONG。(4)RUOCHANFUNINGXUEGONGNENGZHANGAI,ZEJINKUAISHIYONGGANSUFANGZHIWEIXUESHUANXINGCHENG,ZAIJIJIKANGNINGJICHUSHANGYIXUEXIAOBAN、LENGCHENDIAN、XINXIANDEBINGDONGXUEJIANGDENGXIANGGUANXUEZHIPINJINXINGSHUZHUBUCHONG,HUOJIYUYITAIMEI、ANJIAHUANSUANDENGBUCHONGNINGXUEYAO。RUOTONGGUOKANGNINGZHILIAOWUFAQIDAOXIANZHEDEXIAOGUO,YOUQISHIWUFAYIZHIDIZIGONGDACHUXUEQINGKUANGSHI,YINGGAIKAOLVJINXINGZIGONGQIECHUSHU。

                                3、 护理总结

                              牛牛游戏厅安卓,{原始关键词}   YANGSHUISHUANSAIZUOWEIFUCHANKEZHONGYIZHONGYANZHONGXINGJIAOGAODEBINGZHENG,YIDANHUAIYIHUOQUEZHENSHIBIANLIKEJINXINGYOUXIAODECHULIGANYU,YIWANJIUHUANZHESHENGMING。RICHANGHULIGONGZUOZHONG,DUIGAILEIHUANZHEXUZUOHAOSUOYOUZHILIAOXIANGGUANYIQISHEBEIJIYAOPINDEZHUNBEIGONGZUO,MINGQUEJIYANGSHEBEIJIXINDIANJIANHUYIDENGGONGNENGDEWANHAOXING。ZAIHUANZHEFENMIANSHI,YIHURENYUANDUIHUANZHEHUXI、MAIBO、XINLVJIXUEYANGQINGKUANGDENGZUOHAOJIJIJIANHU,YIDANHUAIYIWEIYANGSHUISHUANSAISHILIKEJINXINGXIANGGUANDEZHENZHICHULI,YIMIANDANWULEJIUZHISHIJIAN。

                                ZONGERYANZHI,YANGSHUISHUANSAIDUIYUCHANFUJITAIERLAISHUODOUYOUSHIFENYANZHONGDEYINGXIANG,ZAIWUFABAOTAIDEQINGKUANGXIA,WEILEQUEBAOMUTIDEJIANKANG,BIXUJISHIYOUXIAODIJINXINGXIANGGUANHULIGANYU,YICUJINZHILIAOGONGZUODESHUNLIKAIZHAN,TIGAOHUANZHECUNHUOLV。

                                参考文献

                                [1]陈珊.产科弥散性血管内凝血的研究进展[J].武警后勤学院学报(医学版),2015,8:668~671
                                [2] 李兴亭.护理干预在羊水栓塞产妇中的应用效果观察[J].基层医学论坛,2018,2:258~259

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