“全面二孩”政策后收治ICU的产科危重症患者临床特点分析  

Clinical characteristics analysis of critical patients in obstetric department admitted into the ICU after “universal two-child” policy

作　　者：兰蕴平[1] 曾帆[1] 黎嘉嘉[1] 雷雨[1] 黄晓波[1] LAN Yun-ping;ZENG Fan;LI Jia-jia;LEI Yu;HUANG Xiao-bo(SICU in Intensive Care Unit,Sichuan Provincial People＇s Hospital,Chengdu 610072,China)

机构地区：[1]四川省人民医院重症医学中心SICU,四川成都610072

出　　处：《中国当代医药》2018年第16期4-7,共4页China Modern Medicine

基　　金：四川省医学会医学科研课题计划(S16072)

摘　　要：目的分析"全面二孩"政策后收治ICU的产科危重症患者的临床特点。方法 2016年1月~2017年4月,选取产科危重症患者61例,将其分为高龄组22例、非高龄组39例。比较两组患者的孕龄、新生儿体重、新生儿存活情况、剖宫产次数、产后出血、入住ICU病因、APACHEⅡ评分、SOFA评分、ICU治疗时间、ICU主要治疗措施、住院花费。结果高龄组患者的二孩率明显高于非高龄组,差异有统计学意义(P<0.01)。高龄组的APACHEⅡ评分明显高于非高龄组,差异有统计学意义(P<0.05);ICU治疗时间明显长于非高龄组(P<0.01)。高龄组的血浆置换率和血液滤过率明显高于非高龄组,差异有统计学意义(P<0.05,P<0.01);两组的呼吸机使用率比较,差异无统计学意义(P>0.05)。高高龄组的产后出血发生率明显高于非高龄组,血浆输注量明显多于非高龄组,差异有统计学意义(P<0.05)。高龄组的住院花费明显高于非高龄组,差异有统计学意义(P<0.05)。结论高龄产妇出现急危重症及产后出血的风险更高、血浆制品使用更多、ICU住院时间更长、医疗花费更大,急危重症孕产妇应早期被收治ICU监护治疗,改善其临床结局,降低医疗花费。Objective To analyze the clinical features of critical patients in obstetric department admitted into intensive care unit（ICU） after ＂universal two-child＂ policy.Methods From January 2016 to April 2017,61 critical patients in obstetric department admitted into ICU were divided into the advanced age group（n=22） and non-advanced age group（n=39）.The gestational weeks,newborn weight,neonatal survival,frequency of cesarean section,postpartum hemorrhage,the cause of admission into ICU,APACHE II score,SOFA score,the treatment time in ICU,main treatment measures in ICU,and hospitalization expenses were compared between the two groups.Results The proportion of ＂two-child＂ in the advanced age group was higher than that of the non-advanced age group（P〈0.01）.APACHE Ⅱ score in the advanced age group was significantly higher than that in the non-advanced age group with a statistical difference（P〈0.05）.The treatment time in ICU in the advanced age group was longer（P〈0.01）,and plasma exchange rate and hemodiafiltration rate were greatly higher than those in the non-advanced age group（P〈0.05,P〈0.01）.There was no significant difference in the ventilator utilization between the two groups（P〉0.05）.The incidence of postpartum hemorrhage in the advanced age group was obviously higher than that of the non-advanced age group,and plasma infusion volume of in the advanced age group was much higher than that in the non-advanced age group with a statistical difference（P〈0.05）.The hospitalization cost of the advanced age group was higher than that of the non-advanced age group with a significant difference（P〈0.05）.Conclusion Compared with non-advanced age pregnant women,those in advanced age have a higher risk of critical diseases and postpartum hemorrhage,more use of plasma products,longer ICU stay,and more medical costs.Early admission to ICU for supervision and treatment in these critically ill pregnant women can improve their clinical outcomes and reduce medical expenses.

关 键 词：“全面二孩”政策 高龄 危重症孕产妇 重症监护 

分 类 号：R714.2[医药卫生—妇产科学]