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目的:探讨入住重症监护病房(ICU)的产科患者的临床特征,旨在为此类患者的产科处理提供指导信息。方法:回顾性分析2008年1月~2012年12月在盛京医院就诊的由产科医生和ICU医生共同救治的401例危重孕产妇的临床资料,包括一般情况、疾病构成比、患者预后、ICU住院时间等方面。结果:近5年来在盛京医院孕产妇入ICU治疗的产科相关疾病前3位依次为子痫和子痫前期重度及其相关并发症、产后大出血和妊娠期急性脂肪肝,非产科相关疾病前3位依次为妊娠合并心脏病、妊娠合并重症胰腺炎及妊娠合并脑病。入住ICU比例最高的疾病的前3位依次为妊娠期急性脂肪肝、妊娠合并艾森曼格综合征和妊娠合并重症胰腺炎。引起孕产妇死亡的疾病的前3位依次为子痫及子痫前期重度并发症、妊娠期急性脂肪肝和妊娠合并艾森曼格综合征。入住ICU时间最长的病变前5位依次为:妊娠期急性脂肪肝、HELLP综合征、妊娠合并艾森曼格综合征、妊娠合并重症胰腺炎和羊水栓塞。结论:产科联合ICU治疗危重孕产妇是降低孕产妇发病率和死亡率的有效措施。了解入住ICU的产科患者的临床特征,有助于产科医生早期诊断及处理产科危重症。
Objectives: To investigate the clinical features of obstetric patients admitted to intensive care unit (ICU) to provide guidance on the obstetric management of such patients. Methods: The clinical data of 401 critically ill pregnant women who were treated by obstetricians and ICU doctors at Shengjing Hospital from January 2008 to December 2012 were analyzed retrospectively. The data including general condition, disease constituent ratio, prognosis of patients, ICU Hospitalization time and so on. Results: In the recent 5 years, the top 3 maternity-related diseases in Shengjing Hospital were as follows: preeclampsia and preeclampsia and their related complications, postpartum hemorrhage and acute fatty liver during pregnancy, the first 3 cases of non-obstetric-related diseases Followed by pregnancy were with heart disease, pregnancy complicated with severe pancreatitis and pregnancy complicated with encephalopathy. The top 3 ICU occupying the highest proportion of ICU were acute fatty liver in pregnancy, pregnancy complicated with Eisenmenger syndrome and severe pancreatitis complicated with pregnancy. The top 3 diseases causing maternal death were severe eclampsia and preeclampsia, acute fatty liver during pregnancy and pregnancy complicated with Eisenmenger’s syndrome. The top 5 lesions in the ICU were as follows: acute fatty liver in pregnancy, HELLP syndrome, pregnancy complicated with Eisenmenger syndrome, pregnancy complicated with severe pancreatitis and amniotic fluid embolism. Conclusion: Obstetric combined with ICU in treating critically ill pregnant women is an effective measure to reduce maternal morbidity and mortality. Understanding the clinical characteristics of obstetric patients admitted to the ICU will help obstetricians diagnose and manage obstetric critical illness early.