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剖宫产术后毛细血管通透性增加所致低血容量性休克

[Hypovolemic shock caused by an increase in capillary permeability after cesarean section].

作者信息

Tanguy M, Malledant Y, Beguec J F, Ballay J L, Gaudon M, Dormoy D, Chéreul B, Saint-Marc C

出版信息

Ann Fr Anesth Reanim. 1984;3(5):374-6. doi: 10.1016/s0750-7658(84)80075-1.

Abstract

A 24 year old woman was delivered by caesarean section after an uncomplicated full-term pregnancy. Non-specific prodromes appeared 48 h later, with development of a severe shock. After confirmation of hypovolaemia, attention was focused on the abnormal haematological findings (a sharp drop in serum proteins with a rise in haematocrit) which suggested major leakage of plasma. Treatment based on infusions of plasma and albumin failed, and the patient died in a state of anasarca and pulmonary oedema with normal wedge pressure. 18 similar cases have already been published, six of which were in obstetric or surgical patients. After analysing the prodromes and its onset, its pathophysiological mechanisms and treatment are discussed.

摘要

一名24岁女性在足月妊娠无并发症后行剖宫产分娩。48小时后出现非特异性前驱症状,并发展为严重休克。在确认血容量不足后,注意力集中在异常的血液学检查结果上(血清蛋白急剧下降,血细胞比容升高),这提示血浆大量渗漏。基于输注血浆和白蛋白的治疗失败,患者死于全身水肿和肺水肿状态,楔压正常。已有18例类似病例发表,其中6例为产科或外科患者。在分析了前驱症状及其发作情况后,对其病理生理机制和治疗进行了讨论。

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