本文選題：危重孕產(chǎn)婦 + ICU(重癥監(jiān)護(hù)病房)�。� 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:隨著我國二胎政策的全面開放及醫(yī)學(xué)技術(shù)的發(fā)展,孕產(chǎn)婦的并發(fā)癥增加,危重孕產(chǎn)婦增加,孕產(chǎn)婦的死亡率亦呈增高趨勢。近年來雖然危重孕產(chǎn)婦的文獻(xiàn)報道較多,但因為臨床工作中妊娠與并發(fā)癥相互作用,可能掩蓋實際病情的嚴(yán)重程度,使得可提供的臨床參考數(shù)據(jù)帶有較大的主觀性因素,且危重孕產(chǎn)婦的經(jīng)濟水平、文化教育以及各醫(yī)院醫(yī)療水平的不平衡,導(dǎo)致危重孕產(chǎn)婦入住ICU的疾病分布有差異。本文通過探討近年來入住我院ICU的216例危重孕產(chǎn)婦的一般情況及危重孕產(chǎn)婦及圍產(chǎn)兒結(jié)局,為保障危重孕產(chǎn)婦及圍產(chǎn)兒的生命安全提供可靠的臨床診療資料。方法:回顧性分析山西醫(yī)科大學(xué)第一醫(yī)院從2011年4月1日至2016年4月1日近五年間入住ICU的216例危重孕產(chǎn)婦的一般情況(年齡、孕周、總住院天數(shù)、危重孕產(chǎn)婦及圍產(chǎn)兒死亡情況、疾病病因構(gòu)成)、轉(zhuǎn)診與非轉(zhuǎn)診、規(guī)律產(chǎn)檢(次數(shù)≥5次)與非規(guī)律產(chǎn)檢(5次)及選擇終止妊娠的不同方面對危重孕產(chǎn)婦及圍產(chǎn)兒結(jié)局的影響。結(jié)果:(1)導(dǎo)致入住我院ICU的危重孕產(chǎn)婦最主要病因是妊娠期高血壓疾病及其并發(fā)癥(以子癇前期重度、子癇、HELLP綜合征為主)和產(chǎn)后出血(以前置胎盤、胎盤早剝?yōu)橹?,其次是妊娠合并心臟病;(2)轉(zhuǎn)診與非轉(zhuǎn)診相比,危重孕產(chǎn)婦及圍產(chǎn)兒死亡率差異有統(tǒng)計學(xué)意義(P0.05);(3)規(guī)律產(chǎn)檢(產(chǎn)檢次數(shù)≥5次)與非規(guī)律產(chǎn)檢(產(chǎn)檢次數(shù)5次)相比,危重孕產(chǎn)婦及圍產(chǎn)兒的死亡風(fēng)險有統(tǒng)計學(xué)差異(P0.05),且規(guī)律產(chǎn)檢的孕產(chǎn)婦及圍產(chǎn)兒的死亡率相對偏低;(4)不同的原因、時間終止妊娠相比,危重孕產(chǎn)婦及圍產(chǎn)兒的死亡風(fēng)險有統(tǒng)計學(xué)差異(P0.05);剖宮產(chǎn)與經(jīng)陰道分娩相比,圍產(chǎn)兒的死亡風(fēng)險有統(tǒng)計學(xué)差異(P0.05),但兩者之間危重孕產(chǎn)婦的死亡風(fēng)險無統(tǒng)計學(xué)差異(P0.05)。結(jié)論:(1)危重孕產(chǎn)婦入住ICU最主要的病因是產(chǎn)后出血和妊娠期高血壓疾病;(2)加強危重孕產(chǎn)婦的產(chǎn)前篩查及孕期管理,可以減少危重孕產(chǎn)婦由高危轉(zhuǎn)為危重,減少危重孕產(chǎn)婦及圍產(chǎn)兒的死亡率;(3)在確保危重孕產(chǎn)婦生命安全的前提下,盡可能的使胎兒的孕周延長至34周及以后能明顯減少圍產(chǎn)兒的死亡率。
[Abstract]:Objective: with the opening of the policy of second child and the development of medical technology, the complications of pregnant and lying-in women increased, and the mortality rate of pregnant women increased. In recent years, although there have been many reports on the literature of critical pregnant women, the interaction between pregnancy and complications in clinical work may cover up the severity of the actual condition, which makes the available clinical reference data have more subjective factors. The imbalance of economic level, culture and education and medical treatment level of critical pregnant women led to the difference in the distribution of diseases of critically ill pregnant women admitted to ICU. This paper discusses the general situation and perinatal outcome of 216 critical pregnant women admitted to ICU in our hospital in recent years, and provides reliable clinical diagnosis and treatment data for ensuring the life safety of critical pregnant women and perinatal infants. Methods: a retrospective analysis of 216 critically ill pregnant women admitted to ICU from April 1, 2011 to April 1, 2016 in the first Hospital of Shanxi Medical University (age, gestational week, total hospitalization days) was performed. The influence of the death of critical pregnant women and perinatal infants, the constitution of disease etiology, referrals and non-referrals, regular perinatal examinations (鈮，

本文編號：1886151