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一所三级大学医院重症监护病房产前和产后产科住院患者的结局:一项为期8年的回顾性研究

Outcomes of Antepartum and Postpartum Obstetric Admissions to the Intensive Care Unit of A Tertiary University Hospital: An 8-Year Review.

作者信息

Özçelik Menekşe, Turhan Sanem, Bermede Onat, Yılmaz Ali Abbas, Ünal Necmettin, Bayar Mustafa Kemal

机构信息

Department of Anesthesiology and Reanimation, Ankara University School of Medicine, Ankara, Turkey.

出版信息

Turk J Anaesthesiol Reanim. 2017 Oct;45(5):303-309. doi: 10.5152/TJAR.2017.56323. Epub 2017 Oct 1.

Abstract

OBJECTIVE

Although their rates are decreasing, pregnancy-related mortality and morbidity are problems worldwide. In this study, we aimed to review the characteristics, diagnoses, required interventions and outcomes of obstetric patients admitted between 2006 and 2014 to the Intensive Care Unit (ICU) of a tertiary university hospital to provide an indicator for improving the management of critically ill obstetric patients.

METHODS

A retrospective study of hospital records of obstetric admissions to the ICU was conducted.

RESULTS

The pregnancy-related ICU admission rate was 0.21% among all deliveries during the study period. Nine antepartum (mean gestational age: 23 weeks) and 48 postpartum (mean gestational age: 34 weeks) obstetric ICU admissions were included. Most obstetric patients admitted antepartum were primiparous (88.8%), whereas those admitted postpartum were multiparous (64.6%). The mean ICU stay was 7 days among the patients admitted antepartum and 6 days among those admitted postpartum. Common medical reasons for ICU admission were respiratory failure and HELLP syndrome in both groups; DIC and eclampsia were also medical reasons causing ICU admission among the postpartum patients. Mechanical ventilation and blood derivative transfusion were the most common interventions required during the ICU stay of the obstetric patients. Maternal death was unique to the patients admitted postpartum (6 patients, 12.5%).

CONCLUSION

We reviewed obstetric admissions to our institution over an 8-year period. We believe that a nationwide study in Turkey that provides an indicator of the frequency, reasons of ICU admission and outcome of obstetric patients is required to improve the quality of intensive care.

摘要

目的

尽管与妊娠相关的死亡率和发病率在下降,但仍是全球范围内的问题。在本研究中,我们旨在回顾2006年至2014年间入住一所三级大学医院重症监护病房(ICU)的产科患者的特征、诊断、所需干预措施及结局,以提供改善重症产科患者管理的指标。

方法

对ICU产科住院记录进行回顾性研究。

结果

研究期间,所有分娩中与妊娠相关的ICU入院率为0.21%。纳入9例产前(平均孕周:23周)和48例产后(平均孕周:34周)产科ICU入院患者。产前入住ICU的大多数产科患者为初产妇(88.8%),而产后入住者多为经产妇(64.6%)。产前入院患者的平均ICU住院时间为7天,产后入院患者为6天。两组患者入住ICU的常见医学原因均为呼吸衰竭和HELLP综合征;产后患者入住ICU的医学原因还包括弥散性血管内凝血(DIC)和子痫。机械通气和血液制品输注是产科患者在ICU住院期间最常见的所需干预措施。孕产妇死亡仅发生在产后入院患者中(6例,12.5%)。

结论

我们回顾了本机构8年间的产科入院情况。我们认为,土耳其需要开展一项全国性研究,以提供产科患者入住ICU的频率、原因及结局指标,从而提高重症监护质量。

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