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[一例26周孕妇紧急剖宫产及开颅手术病例]

[A Case of Emergency Cesarean Section and Craniotomy in a 26 Week Pregnant Woman].

作者信息

Matsuda Megumi, Yamazaki Marie, Osada Junko, Hirata Manabu, Amaya Fumimasa

出版信息

Masui. 2015 Feb;64(2):192-5.

Abstract

Intracranial hemorrhage is a rare complication during the pregnancy but carries a poor prognosis. We experienced a case of emergency cesarean section and craniotomy for removal of hematoma due to arteriovenous malformation (AVM) rupture. A 33-year-old woman at 26 weeks of pregnancy suffered a sudden onset of headache and disturbance of consciousness. She was diagnosed with left cerebral hemorrhage due to AVM rupture. Emergency cesarean section was followed by the surgical removal of the hematoma under general anesthesia. Postoperative courses of both mother and baby were satisfactory. The severity of illness of the mother strongly influences her fetus and vise versa. When performing cesarean section before craniotomy, anesthesia should be managed to prevent recurrence of intracranial hemorrhage during the cesarean section and atonic bleeding during the craniotomy. Anesthetist should have adequate knowledge and communicate adequately with obstetrician and pediatrician to achieve better prognosis for the intracranial hemorrhage during pregnancy.

摘要

颅内出血是孕期罕见的并发症,但预后较差。我们遇到了一例因动静脉畸形(AVM)破裂而紧急行剖宫产及开颅血肿清除术的病例。一名怀孕26周的33岁女性突然出现头痛和意识障碍。她被诊断为因AVM破裂导致左脑出血。紧急剖宫产术后,在全身麻醉下进行了血肿清除手术。母婴术后病程均令人满意。母亲的病情严重程度会强烈影响其胎儿,反之亦然。在开颅手术前行剖宫产时,应妥善管理麻醉,以防止剖宫产期间颅内出血复发及开颅手术时出现宫缩乏力性出血。麻醉医生应具备足够的知识,并与产科医生和儿科医生进行充分沟通,以改善孕期颅内出血的预后。

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