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羊水栓塞:从病理学角度看病理生理学

Amniotic fluid embolism: Pathophysiology from the perspective of pathology.

作者信息

Tamura Naoaki, Farhana Mustari, Oda Tomoaki, Itoh Hiroaki, Kanayama Naohiro

机构信息

Department of Obstetrics & Gynaecology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

出版信息

J Obstet Gynaecol Res. 2017 Apr;43(4):627-632. doi: 10.1111/jog.13284. Epub 2017 Feb 11.

Abstract

Amniotic fluid embolism (AFE) is recognized as a type of syndrome characterized by the abrupt onset of hypoxia, hypotension, seizures, or disseminated intravascular coagulopathy (DIC), occurring during labor, delivery, or immediately postpartum, caused by the inflow of amniotic components into the maternal circulation. AFE is a rare condition but one of the most serious obstetrical complications, resulting in a high mortality rate among pregnant women. Despite earlier recognition and intensive critical management, we often encounter patients who unfortunately do not recover from the exacerbation of AFE-related conditions. A major concern is that there are no effective evidence-based therapies for AFE, because its pathophysiology is still not well understood. This article reviewed AFE, focusing on the pathology and currently proposed pathophysiology.

摘要

羊水栓塞(AFE)是一种综合征,其特征为在分娩、生产过程中或产后立即出现缺氧、低血压、惊厥或弥散性血管内凝血(DIC)的突然发作,这是由羊水成分进入母体循环所引起的。羊水栓塞是一种罕见病症,但却是最严重的产科并发症之一,导致孕妇死亡率很高。尽管能够较早识别并进行强化的重症管理,但我们仍经常遇到一些患者,不幸的是,他们并未从羊水栓塞相关病情的恶化中康复。一个主要问题是,目前尚无针对羊水栓塞的有效循证疗法,因为其病理生理学仍未得到充分了解。本文对羊水栓塞进行了综述,重点关注其病理学及目前提出的病理生理学。

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