在英国怀孕期间或分娩后立即进行肺吸气:基于人口的病例控制研究
Nuala Lucas1, Alison Gooda2, Ruth Tunn2
1London North West Healthcare NHS Trust, Watford Road, Harrow, Middlesex, HA1 3UJ, UK.
怀孕期间的肺吸血很少见,但存在风险,特别是剖腹产时的全身麻醉. 这项研究强调了识别有风险的孕妇的重要性,以改善结果.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 公共卫生监督 公共卫生监督
背景情况:
- 胃部内容物的肺吸收是通用麻醉下呼吸道管理期间导致死亡的首要原因.
- 怀孕会增加吸血风险,原因是胃排空延迟和胃内压力增加.
- 怀孕期间母亲的肺吸血对母亲和婴儿都有很大的风险.
研究的目的:
- 为了确定英国母亲肺吸气的发病率.
- 确定与母亲肺吸血相关的风险因素,管理策略和结果.
- 为临床实践和未来的研究提供信息,以预防孕妇的渴望.
主要方法:
- 使用英国产科监测系统 (UKOSS) 进行了基于人口的监测和病例控制研究.
- 从2013年9月到2016年8月,在分娩妇女中发现肺吸气病例的前景鉴定.
- 从之前的UKOSS研究 (2005-2014) 中与对照组 (n=1982) 进行比较,以探索风险因素和结果.
主要成果:
- 产妇肺吸气的发生率为每10万个产妇中5.2例.
- 吸血与在全身麻醉下剖腹产 (OR 24.89) 和更短的孕期有显著的关联.
- 吸气的妇女更有可能需要密集治疗,他们的婴儿有较差的结果,包括较低的Apgar分数和增加的NICU入院或死产.
结论:
- 产妇肺吸气是英国产科麻醉中罕见但严重的并发症.
- 剖腹产时的全身麻醉是显著的风险因素.
- 需要进行进一步的研究,以开发准确识别有渴望风险的孕妇的方法.
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