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[羊水栓塞:一例首发心脏骤停和早期弥漫性血管内凝血并伴有医源性血腹和肝腺瘤出血的成功救治病例报告]

[Amniotic fluid embolism: report of the successful outcome of a case with inaugural cardiac arrest and early DIVC complicated by hemoperitoneum of iatrogen origin and bleeding of an hepatic adenoma].

作者信息

Falzone E, Ricard J-D, Pachy F, Mandelbrot L, Keïta H

机构信息

Département d'anesthésie-réanimation, HIA Percy, 101, avenue Henri-Barbusse, BP 406, 92141 Clamart cedex, France.

出版信息

Ann Fr Anesth Reanim. 2012 Oct;31(10):802-5. doi: 10.1016/j.annfar.2012.07.004. Epub 2012 Aug 24.

Abstract

Amniotic fluid embolism is a relatively rare clinical entity and with difficult medical recognition. However, it is the second leading cause of maternal mortality. We report here the case of a 32-year-old patient who underwent elective caesarean section complicated by an amniotic fluid embolism with cardiac arrest. The presence of a major disseminated intravascular coagulation favored the occurrence of a retroperitoneal hematoma of iatrogenic origin on attempt of femoral venous catheterization and that of hemoperitoneum on bleeding of an hepatic adenoma. The diagnostic of amniotic fluid embolism was confirmed by the presence of amniotic cells in the bronchoalveolar lavage. The patient survived without sequelae.

摘要

羊水栓塞是一种相对罕见的临床病症,医学上难以识别。然而,它是孕产妇死亡的第二大原因。我们在此报告一例32岁患者,该患者接受择期剖宫产时并发羊水栓塞并心脏骤停。严重的弥散性血管内凝血导致在尝试进行股静脉置管时发生医源性腹膜后血肿,以及肝腺瘤出血时发生腹腔积血。支气管肺泡灌洗中存在羊水细胞证实了羊水栓塞的诊断。患者存活且无后遗症。

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