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一、诊断及鉴别诊断羊水栓塞是一种严重的产科并发症,起病急骤,病情凶险,死亡率高。病因是羊水及其内容物(如上皮细胞、毳毛、角化物质、胎脂、胎粪和粘液等有形颗粒物质)进入母体血循环,堵塞肺血管,引起肺动脉高压、过敏性休克、弥散性血管内凝血(DIC)三个主要方面的严重而复杂的病理生理变化。(一)临床经过第一阶段是分娩时或分娩后短时间内发生休克,同时可有烦躁不安、寒颤、呕吐、咳嗽、呼吸困难、紫绀、心率快、肺部出现湿罗音等征象。第二阶段主要是出血、血液不凝。第三阶段主要表现为肾功能衰竭。上述三阶段又称三大症候群,基本按顺序出现,但三者出现都很快,呼吸困难与凝血障碍可同时发生,且迅速出现肾功能衰竭。有时三
First, the diagnosis and differential diagnosis of amniotic fluid embolism is a serious obstetric complications, rapid onset, dangerous condition, high mortality. The cause is amniotic fluid and its contents (such as epidermal cells, vellus hair, keratin, fetal fat, meconium and other visible particulate matter) into the maternal blood circulation, blocking the pulmonary blood vessels, causing pulmonary hypertension, anaphylactic shock, diffuse blood vessels Serious and complex pathophysiological changes in the three major aspects of intravascular coagulation (DIC). (A) After the first phase of clinical delivery or postpartum shock occurred within a short time, at the same time may have irritability, chills, vomiting, coughing, dyspnea, cyanosis, rapid heart rate, lungs appear wet rales and other signs. The second stage is mainly bleeding, blood coagulation. The third stage mainly manifested as renal failure. The three phases, also known as the three major syndromes, basically appear in order, but the three are fast, dyspnea and coagulopathy can occur simultaneously, and rapid renal failure. Sometimes three