\u672c\u6587\u520a\u767b\u4e8e\u300a\u4e2d\u56fd\u5b9e\u7528\u5987\u79d1\u4e0e\u4ea7\u79d1\u6742\u5fd7\u300b2024,40(5)\uff1a526-534<\/p>\n
DOI\uff1a10.19538\/j.fk2024050112<\/p>\n
\u3010\u5f15\u7528\u672c\u6587\u3011\u4e2d\u56fd\u4f18\u751f\u79d1\u5b66\u534f\u4f1a.\u4ea7\u79d1\u5371\u6025\u91cd\u75c7\u65e9\u671f\u8bc6\u522b\u4e2d\u56fd\u4e13\u5bb6\u5171\u8bc6\uff082024\u5e74\u7248\uff09\uff3bJ\uff3d.\u4e2d\u56fd\u5b9e\u7528\u5987\u79d1\u4e0e\u4ea7\u79d1\u6742\u5fd7\uff0c2024,40(5)\uff1a526-534.<\/p>\n
\u4f5c\u8005\uff1a\u4e2d\u56fd\u4f18\u751f\u79d1\u5b66\u534f\u4f1a<\/p>\n
\u57fa\u91d1\u9879\u76ee\uff1a\u56fd\u5bb6\u81ea\u7136\u79d1\u5b66\u57fa\u91d1\uff0831470886\uff09\uff1b\u91cd\u5e86\u5e02\u81ea\u7136\u79d1\u5b66\u57fa\u91d1\u9762\u4e0a\u9879\u76ee\uff08cstc2019jcyj-msxmX0449\uff09\uff1b\u91cd\u5e86\u5e02\u536b\u751f\u9002\u5b9c\u6280\u672f\u63a8\u5e7f\u9879\u76ee\uff082022jstg050\uff09\uff1b\u91cd\u5e86\u5e02\u6280\u672f\u521b\u65b0\u4e0e\u5e94\u7528\u53d1\u5c55\u4e13\u9879\u91cd\u70b9\u9879\u76ee\uff08CSTB2022TIAD-KPX0173\uff09 <\/p>\n
\u901a\u8baf\u4f5c\u8005\uff1a\u5e38\u9752\uff0c\u9646\u519b\u519b\u533b\u5927\u5b66\u7b2c\u4e00\u9644\u5c5e\u533b\u9662\u5987\u4ea7\u79d1\uff0c\u91cd\u5e86 400038\uff0c\u7535\u5b50\u4fe1\u7bb1\uff1acqli99@tmmu.edu.cn\uff1b\u674e\u529b\uff0c\u9646\u519b\u519b\u533b\u5927\u5b66\u9646\u519b\u7279\u8272\u533b\u5b66\u4e2d\u5fc3\u5927\u576a\u533b\u9662\uff0c\u91cd\u5e86 400042\uff0c\u7535\u5b50\u4fe1\u7bb1\uff1acqlili@tmmu.edu.cn<\/p>\n
\u6267\u7b14\u4f5c\u8005\uff1a\u5e38\u9752\uff08\u9646\u519b\u519b\u533b\u5927\u5b66\u7b2c\u4e00\u9644\u5c5e\u533b\u9662\uff09\uff1b\u674e\u529b\uff08\u9646\u519b\u519b\u533b\u5927\u5b66\u9646\u519b\u7279\u8272\u533b\u5b66\u4e2d\u5fc3\u5927\u576a\u533b\u9662\uff09\uff1b\u4e25\u5c0f\u4e3d\uff08\u9646\u519b\u519b\u533b\u5927\u5b66\u7b2c\u4e00\u9644\u5c5e\u533b\u9662\uff09<\/p>\n
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\u672c\u5171\u8bc6\u4ece\u5b55\u4ea7\u5987\u75c5\u53f2\u548c\u75c7\u72b6\u3001\u598a\u5a20\u5408\u5e76\u57fa\u7840\u75be\u75c5\u3001\u5e76\u53d1\u75c7\u53ca\u4e0d\u826f\u5b55\u4ea7\u53f2\u3001\u4f53\u5f81\u3001\u5b9e\u9a8c\u5ba4\u53ca\u5f71\u50cf\u5b66\u68c0\u67e5\u7b495\u65b9\u9762\u8bc4\u4f30\u53ef\u80fd\u53d1\u751f\u6216\u5373\u5c06\u51fa\u73b0\u7684\u4e34\u5e8a\u5371\u6025\u72b6\u6001\uff0c\u63d0\u9192\u533b\u62a4\u4eba\u5458\u7efc\u5408\u8bc4\u4f30\uff0c\u5bc6\u5207\u76d1\u6d4b\uff0c\u5c3d\u65e9\u542f\u52a8MDT\uff0c\u53ca\u65f6\u6709\u6548\u5e72\u9884\u6216\u79ef\u6781\u8f6c\u8bca\uff0c\u4ee5\u671f\u83b7\u5f97\u6bcd\u513f\u826f\u597d\u7ed3\u5c40\u3002\u672c\u4e13\u5bb6\u5171\u8bc6\u5df2\u5728\u56fd\u9645\u5b9e\u8df5\u6307\u5357\u6ce8\u518c\u4e0e\u900f\u660e\u5316\u5e73\u53f0\uff08Practice Guideline Registration for transparency PREPARE\uff0chttp\uff1a\/\/www.guidelines- registry.cn\uff09\u8fdb\u884c\u53cc\u8bed\u6ce8\u518c\uff08PREPARE-2024CN241\uff09\u3002<\/p>\n
1<\/p>\n
\u75c5\u53f2\u53ca\u75c7\u72b6<\/p>\n
1.1 \u75bc\u75db \u598a\u5a20\u671f\u8f7b-\u4e2d\u5ea6\u949d\u75db\uff0c\u4f11\u606f\u540e\u597d\u8f6c\uff0c\u5e38\u4e3a\u751f\u7406\u73b0\u8c61\u3002\u75c5\u7406\u6027\u75bc\u75db\u591a\u4e3a\u4e2d-\u91cd\u5ea6\uff0c\u5448\u6301\u7eed\u6027\u6216\u4f34\u6709\u5176\u4ed6\u75c7\u72b6\uff0c\u9664\u5916\u65e2\u5f80\u6162\u6027\u75bc\u75db\uff0c\u4ea7\u79d1\u60a3\u8005\u5e38\u4ee5\u6025\u6027\u75bc\u75db\u5c31\u8bca\uff0c\u4e3b\u8981\u6709\u8179\u75db\u3001\u5934\u75db\u3001\u80f8\u75db\u3001\u8170\u80cc\u75db\u7b49\u3002<\/p>\n
1.1.1 \u8179\u75db \u598a\u5a20\u671f\u8179\u75db\u75c5\u56e0\u7e41\u6742\uff0c\u75c5\u60c5\u591a\u53d8\uff0c\u8bca\u6cbb\u4e0d\u53ca\u65f6\u53ef\u80fd\u51fa\u73b0\u610f\u5916\u751a\u81f3\u6b7b\u4ea1\u3002\u5b55\u4ea7\u5987\u8179\u90e8\u4e2d-\u91cd\u5ea6\u75bc\u75db\uff0c\u5448\u6301\u7eed\u949d\u75db\u6216\u77ed\u6682\u6495\u88c2\u6837\u75db\u4e14\u65e0\u6cd5\u5fcd\u53d7\uff0c\u7ecf\u9002\u5f53\u4f11\u606f\u65e0\u7f13\u89e3\u6216\u4f34\u5176\u4ed6\u75c7\u72b6\u4e3a\u5371\u6025\u91cd\u75c7\u9884\u8b66\u4fe1\u53f7\u4e4b\u4e00\u3002<\/p>\n
\u4ea7\u79d1\u539f\u56e0\u4e3b\u8981\u6709\uff1a\uff081\uff09\u5b55\u65e9\u4e2d\u671f\u6d41\u4ea7\u3001\u5f02\u4f4d\u598a\u5a20\u3001\u5b50\u5bab\u7622\u75d5\u90e8\u4f4d\u598a\u5a20\u7834\u88c2\u3001\u5b50\u5bab\u808c\u7624\u7ea2\u8272\u53d8\u6027\u3002\uff082\uff09\u5b55\u4e2d\u665a\u671f\u6d41\u4ea7\u6216\u65e9\u4ea7\u3001\u80ce\u76d8\u65e9\u5265\uff08\u8bc1\u636e\u7b49\u7ea73A\uff0cB\u7c7b\u63a8\u8350\uff09\u7b49\uff3b1-3\uff3d\uff0c\u6ce8\u610f\u6392\u67e5\u5b50\u5bab\u7834\u88c2\uff08\u8bc1\u636e\u7b49\u7ea73A\uff0cB\u7c7b\u63a8\u8350\uff09\uff3b4-6\uff3d\u3002\u975e\u598a\u5a20\u5e76\u53d1\u75c7\u5f15\u8d77\u7684\u8179\u75db\u591a\u53d1\u751f\u5728\u4f34\u6709\u9ad8\u8840\u538b\u6216\u5b50\u75eb\u524d\u671f\/\u5b50\u75eb\u65f6\uff0c\u53f3\u4e0a\u8179\u75db\u5e94\u8b66\u60d5HELLP\u7efc\u5408\u5f81\u3001\u809d\u5305\u819c\u4e0b\u8840\u80bf\uff08\u8bc1\u636e\u7b49\u7ea73A\uff0cB\u7c7b\u63a8\u8350\uff09\uff3b7-9\uff3d\u3002\u975e\u4ea7\u79d1\u539f\u56e0\u5f15\u8d77\u8179\u75db\u6700\u5e38\u89c1\u4e3a\u9644\u4ef6\u80bf\u7269\u626d\u8f6c\u6216\u7834\u88c2\u3002\u5916\u79d1\u56e0\u7d20\u5305\u62ec\u80be\u7ede\u75db\u3001\u6025\u6027\u9611\u5c3e\u708e\u3001\u6025\u6027\u80c6\u56ca\u708e\u3001\u6025\u6027\u80f0\u817a\u708e\u3001\u80a0\u6897\u963b\u3001\u80a0\u7cfb\u819c\u8840\u7ba1\u6813\u585e\u3001\u80be\u810f\u9519\u6784\u7624\u7834\u88c2\u7b49\uff08\u8bc1\u636e\u7b49\u7ea73A\uff0cB\u7c7b\u63a8\u8350\uff09\uff3b10-12\uff3d\u3002\u82e5\u75bc\u75db\u5411\u80f8\u80cc\u90e8\u653e\u5c04\u5e94\u8003\u8651\u5230\u4e3b\u52a8\u8109\u5939\u5c42\u6495\u88c2\u3002<\/p>\n
1.1.2 \u5934\u75db\u3001\u80f8\u75db \u5934\u75db\u53ef\u89c1\u4e8e\u7cbe\u795e\u7d27\u5f20\u3001\u8fc7\u5ea6\u75b2\u52b3\u3001\u611f\u67d3\u3001\u8840\u7ba1\u75c5\u53d8\u3001\u9885\u5185\u5360\u4f4d\u6027\u75c5\u53d8\u7b49\u3002\u5934\u75db\u7a0b\u5ea6\u4e0e\u75c5\u60c5\u8f7b\u91cd\u65e0\u5e73\u884c\u5173\u7cfb\uff3b13\uff3d\u3002\u5b55\u4ea7\u5987\u5934\u75db\u5e38\u89c1\u4e8e\u8840\u538b\u5f02\u5e38\u5bfc\u81f4\u9885\u5185\u8840\u7ba1\u75c9\u631b\u3002\u5b55\u5987\u51fa\u73b0\u5934\u75db\u65f6\u987b\u5bc6\u5207\u5173\u6ce8\u8840\u538b\uff0c\u5b50\u75eb\u662f\u5b55\u4ea7\u5987\u75c5\u6b8b\u548c\u6b7b\u4ea1\u7684\u91cd\u8981\u539f\u56e0\uff08\u8bc1\u636e\u7b49\u7ea72A\uff0cB\u7c7b\u63a8\u8350\uff09\uff3b14-16\uff3d\u3002\u6025\u5267\u5934\u75db\uff0c\u4f34\u6709\u4e0d\u540c\u7a0b\u5ea6\u610f\u8bc6\u969c\u788d\u6216\u56db\u80a2\u6d3b\u52a8\u969c\u788d\u3001\u9888\u9879\u5f3a\u76f4\u53ca\u77b3\u5b54\u53d8\u5316\uff0c\u63d0\u793a\u8111\u51fa\u8840\u53ef\u80fd\uff3b17\uff3d\u3002\u5934\u75db\u4f34\u6709\u6076\u5fc3\u3001\u5455\u5410\uff0c\u5e94\u8b66\u60d5\u9885\u5185\u9ad8\u538b\uff0c\u5408\u5e76\u9885\u5185\u80bf\u7624\u7b49\u3002\u53cd\u590d\u53d1\u4f5c\u6216\u6301\u7eed\u7684\u5934\u75db\uff0c\u5e94\u6ce8\u610f\u6392\u9664\u9885\u5185\u9759\u8109\u7aa6\u8840\u6813\u3001\u8111\u6897\u6b7b\u3002<\/p>\n
\u598a\u5a20\u671f\u80f8\u75db\u5c11\u89c1\uff0c\u9700\u8b66\u60d5\u5fc3\u8840\u7ba1\u75be\u75c5\uff08\u8bc1\u636e\u7b49\u7ea72A\uff0cB\u7c7b\u63a8\u8350\uff09\uff3b18\uff3d\uff0c\u5982\u80ba\u6813\u585e\u3001\u6025\u6027\u4e3b\u52a8\u8109\u5939\u5c42\u3001\u5fc3\u808c\u75c5\u3001\u6025\u6027\u51a0\u8109\u7efc\u5408\u5f81\u7b49\uff3b19\uff3d\u3002\u6025\u6027\u4e3b\u52a8\u8109\u5939\u5c42\u662f\u6781\u5371\u9669\u7684\u5fc3\u810f\u5927\u8840\u7ba1\u6025\u75c7\uff1b\u598a\u5a20\u4e3b\u52a8\u8109\u5939\u5c42\u53d1\u75c5\u7387\u4e3a\uff080.4\uff5e0.5\uff09\/10\u4e07\uff0c\u53d1\u75c5\u6025\u3001\u75c5\u6b7b\u7387\u9ad8\u8fbe60%\uff3b20\uff3d\uff0c\u65e9\u671f\u8bc6\u522b\u5c24\u4e3a\u91cd\u8981\u3002\u5b55\u4ea7\u5987\u5e76\u53d1\u6025\u6027\u4e3b\u52a8\u8109\u5939\u5c42\u5e38\u89c1\u9ad8\u5371\u56e0\u7d20\u5305\u62ec\u9ad8\u8840\u538b\u3001\u7cd6\u5c3f\u75c5\u3001\u4e3b\u52a8\u8109\u53d1\u80b2\u5f02\u5e38\u53ca\u75c5\u53d8\u3001\u5916\u4f24\u3001\u9057\u4f20\u6027\u7ed3\u7f14\u7ec4\u7ec7\u75c5\uff08Manfan\u7efc\u5408\u5f81\u7b49\uff09 \u7b49\uff08\u8bc1\u636e\u7b49\u7ea73A\uff0cB\u7c7b\u63a8\u8350\uff09\uff3b21-23\uff3d\u3002\u6700\u5e38\u89c1\u75c7\u72b6\u662f\u7a81\u53d1\u6495\u88c2\u6837\u5267\u70c8\u80f8\u3001\u80cc\u75db\uff08\u7ea6\u536090%\uff09\uff0c\u75bc\u75db\u5267\u70c8\u96be\u4ee5\u5fcd\u53d7\uff0c\u5448\u5200\u5272\u6216\u6495\u88c2\u6837\uff0c\u53ef\u5411\u9888\u90e8\u53ca\u8179\u90e8\u653e\u5c04\uff0c\u6613\u88ab\u5bab\u7f29\u65f6\u8179\u75db\u6240\u63a9\u76d6\u3002\u968f\u7740\u4e3b\u52a8\u8109\u5939\u5c42\u5206\u79bb\u7684\u6269\u5c55\u5ef6\u4f38\uff0c\u75bc\u75db\u53ef\u5448\u73b0\u8f6c\u79fb\u6027\uff0c\u4e5f\u53ef\u4e3a\u9690\u75db\uff0c\u6301\u7eed\u65f6\u95f4\u957f\uff0c\u9635\u53d1\u6027\u52a0\u5267\u3002\u9759\u8109\u8840\u6813\u6813\u585e\u75c7\uff08venous thromboembolism\uff0cVTE\uff09\u662f\u6df1\u9759\u8109\u8840\u6813\u5f62\u6210\uff08deep vein thrombosis\uff0cDVT\uff09\u548c\u80ba\u6813\u585e\uff08pulmonary embolism\uff0cPE\uff09\u7684\u7edf\u79f0\u3002PE\u4e34\u5e8a\u8868\u73b0\u591a\u6837\u3001\u7f3a\u4e4f\u7279\u5f02\u6027\uff0c\u5178\u578b\u8005\u4e3a\u80f8\u75db\u3001\u547c\u5438\u56f0\u96be\uff3b24\uff3d\u3002\u598a\u5a20\u665a\u671f\u6709\u751f\u7406\u6027\u9ad8\u51dd\u72b6\u6001\uff0c\u591a\u6570DVT\u8005\u65e9\u671f\u65e0\u75c7\u72b6\u6216\u4e34\u5e8a\u8868\u73b0\u7f3a\u4e4f\u7279\u5f02\u6027\uff0c\u5e94\u79ef\u6781\u884c\u4e0b\u80a2\u8840\u7ba1\u8d85\u58f0\u6392\u9664DVT\uff0c\u5bf9\u9ad8\u5371\u4eba\u7fa4\u91c7\u53d6DVT\u9884\u9632\u63aa\u65bd\uff3b25\uff3d\u3002<\/p>\n
1.1.3 \u8170\u80cc\u75db \u598a\u5a20\u4e2d\u665a\u671f\u8f7b-\u4e2d\u5ea6\u8170\u80cc\u75db\uff0c\u9002\u5f53\u4f11\u606f\u591a\u53ef\u7f13\u89e3\uff0c\u5408\u5e76\u4e0b\u80a2\u653e\u5c04\u6837\u75bc\u75db\u5e94\u8003\u8651\u690e\u95f4\u76d8\u7a81\u51fa\u6216\u5750\u9aa8\u795e\u7ecf\u75db\u7b49\uff0c\u9700\u8bf7\u4e13\u79d1\u4f1a\u8bca\u3002\u5982\u53d1\u751f\u4e2d-\u91cd\u5ea6\u6216\u6301\u7eed\u52a0\u91cd\u8170\u80cc\u75db\u9700\u8b66\u60d5\u6ccc\u5c3f\u7cfb\u7edf\u75be\u75c5\uff08\u8bc1\u636e\u7b49\u7ea73A\uff0cB\u7c7b\u63a8\u8350\uff09\uff3b26\uff3d\u3002\u598a\u5a20\u671f\u5b50\u5bab\u589e\u5927\u538b\u8feb\u6216\u5408\u5e76\u6ccc\u5c3f\u7cfb\u7ed3\u77f3\u65f6\uff0c\u6613\u51fa\u73b0\u80be\u79ef\u6c34\u6216\u8f93\u5c3f\u7ba1\u6269\u5f20\uff0c\u53f3\u80be\u76f8\u5bf9\u5e38\u89c1\u3002\u80be\u79ef\u6c34\u5408\u5e76\u611f\u67d3\u65f6\uff0c\u5e38\u4e3a\u5267\u70c8\u96be\u5fcd\u7ede\u75db\uff0c\u9635\u6027\u53d1\u4f5c\uff0c\u53ef\u4f34\u6709\u8840\u5c3f\u3001\u86cb\u767d\u5c3f\uff0c\u6076\u5fc3\u3001\u5455\u5410\u7b49\u3002\u5f53\u51fa\u73b0\u9ad8\u70ed\u3001\u5bd2\u6218\u53ef\u80fd\u5408\u5e76\u4e25\u91cd\u611f\u67d3\uff0c\u9700\u79ef\u6781\u6297\u611f\u67d3\u3001\u5fc5\u8981\u65f6\u653e\u7f6e\u8f93\u5c3f\u7ba1\u652f\u67b6\uff3b27-28\uff3d\uff0c\u5904\u7406\u4e0d\u53ca\u65f6\u53ef\u8fdb\u5c55\u4e3a\u8113\u6bd2\u75c7\uff0c\u5371\u53ca\u6bcd\u513f\u751f\u547d\u3002\u6025\u6027\u80f0\u817a\u708e\u3001\u80c6\u56ca\u708e\u3001\u80c6\u7ba1\u708e\u3001\u6d88\u5316\u9053\u75be\u75c5\u53ef\u80fd\u4f1a\u5bfc\u81f4\u4e2d-\u91cd\u5ea6\u7684\u8170\u80cc\u75db\u3001\u6301\u7eed\u949d\u75db\u3001\u80c0\u75db\u6216\u5200\u5272\u3001\u6495\u88c2\u6837\u75db\u3002\u7f55\u89c1\u75c5\u56e0\u8fd8\u6709\uff1a\u80f8\u819c\u708e\u3001\u80ba\u7ed3\u6838\u3001\u80ba\u764c\u3001\u4e3b\u52a8\u8109\u5939\u5c42\u6495\u88c2\u3001\u80be\u810f\u9519\u6784\u7624\u7834\u88c2\u7b49\u3002<\/p>\n
1.2 \u80f8\u95f7\u3001\u547c\u5438\u56f0\u96be \u5b55\u5987\u5b55\u665a\u671f\u8f83\u5e38\u89c1\u80f8\u95f7\u3001\u6c14\u4fc3\uff0c\u8f7b\u5fae\u6d3b\u52a8\u540e\u52a0\u91cd\uff1b\u5982\u679c\u4f11\u606f\u540e\u5b55\u5987\u5fc3\u7387\uff1e110\u6b21\/min\u3001\u547c\u5438\u9891\u7387\uff1e20\u6b21\/min\uff0c\u591c\u95f4\u9700\u9ad8\u6795\u7761\u7720\u3001\u5750\u4f4d\u547c\u5438\uff08\u591c\u95f4\u9635\u53d1\u6027\u547c\u5438\u56f0\u96be\uff09\u6216\u542c\u8bca\u80ba\u5e95\u51fa\u73b0\u5c11\u91cf\u6301\u7eed\u6027\u6e7f\u6027\u5570\u97f3\uff0c\u54b3\u55fd\u540e\u4e0d\u6d88\u5931\uff0c\u5e94\u8b66\u60d5\u65e9\u671f\u5fc3\u529b\u8870\u7aed\uff08\u5fc3\u8870\uff09\uff3b29\uff3d\u3002<\/p>\n
\u598a\u5a20\u671f\u80ba\u6c34\u80bf\u5e38\u89c1\u539f\u56e0\u6709\u5b50\u75eb\u524d\u671f\u3001\u5fc3\u810f\u75c5\u3001\u4f7f\u7528\u5bab\u7f29\u6291\u5236\u5242\u53ca\u533b\u6e90\u6027\u5bb9\u91cf\u8d85\u8d1f\u8377\u7b49\uff08\u8bc1\u636e\u7b49\u7ea73A\uff0cB\u7c7b\u63a8\u8350\uff09\uff3b30\uff3d\u3002\u90e8\u5206\u5b55\u5987\u5b55\u665a\u671f\u547c\u5438\u6025\u4fc3\uff0c\u53ef\u80fd\u51fa\u73b0\u8fc7\u5ea6\u901a\u6c14\u7efc\u5408\u5f81\u6216\u4f4e\u9499\u8840\u75c7\uff0c\u60a3\u8005\u624b\u3001\u8db3\u548c\u53e3\u5468\u53ef\u80fd\u51fa\u73b0\u9ebb\u6728\u548c\u9488\u523a\u611f\u3001\u808c\u9707\u98a4\u3001\u624b\u8db3\u6410\u6426\u7b49\u75c7\u72b6\uff0c\u53ef\u6709\u7729\u6655\u3001\u80f8\u75db\u3001\u80f8\u95f7\u3001\u795e\u5fd7\u6de1\u6f20\u3001\u610f\u8bc6\u969c\u788d\u7b49\u8868\u73b0\u3002<\/p>\n
2<\/p>\n
\u598a\u5a20\u5408\u5e76\u57fa\u7840\u75be\u75c5\u3001\u4e0d\u826f\u5b55\u4ea7\u53f2<\/p>\n
\u598a\u5a20\u5408\u5e76\u5b50\u75eb\u524d\u671f\/\u5b50\u75eb\u3001\u5fc3\u810f\u75be\u75c5\u662f\u6211\u56fd\u5b55\u4ea7\u5987\u6b7b\u4ea1\u7684\u4e3b\u8981\u539f\u56e0\u3002\u598a\u5a20\u53ef\u5f15\u8d77\u8d2b\u8840\u3001\u7cd6\u4ee3\u8c22\u3001\u7532\u72b6\u817a\u529f\u80fd\u5f02\u5e38\uff0c\u52a0\u91cd\u514d\u75ab\u76f8\u5173\u75be\u75c5\u3001\u5fc3\u8840\u7ba1\u75be\u75c5\u3001\u80be\u75c5\u7b49\u75c5\u60c5\u3002\u598a\u5a20\u671f\u5408\u5e76\u5185\u5916\u79d1\u75be\u75c5\uff0c\u9700\u4e25\u5bc6\u76d1\u6d4b\u57fa\u7840\u75be\u75c5\u7684\u75c5\u60c5\u53d8\u5316\uff0c\u53ca\u65f6\u4e13\u79d1\u8bc4\u4f30\u3002\u5b55\u5987\u5b55\u671f\u5e38\u89c4\u68c0\u67e5\u5fc3\u7535\u56fe\u53d1\u73b0\u5f02\u5e38\u6216\u51fa\u73b0\u80f8\u95f7\u3001\u6c14\u4fc3\uff0c\u5fc3\u7387\u548c\uff08\u6216\uff09\u5fc3\u5f8b\u5f02\u5e38\u9700\u53ca\u65f6\u884c\u5fc3\u810f\u8d85\u58f0+\u5fc3\u529f\u80fd\u68c0\u67e5\u6392\u9664\u5fc3\u810f\u5668\u8d28\u6027\u75c5\u53d8\uff0c\u5fc5\u8981\u65f6\u884c\u5fc3\u8870\u6807\u5fd7\u7269\u68c0\u6d4b\uff3b\u5fc3\u808c\u9176\u8c31\u3001B\u578b\u8111\u94a0\u80bd\uff08BNP\uff09\u3001\u808c\u9499\u86cb\u767d\uff3d\u6392\u9664\u5fc3\u529f\u80fd\u4e0d\u5168\u3002\u5b55\u671f\u8840\u7cd6\u5f02\u5e38\uff08\u8840\u7cd6\u589e\u9ad8\u6216\u4f4e\u8840\u7cd6\uff09\uff0c\u5e94\u5c3d\u5feb\u8bca\u6cbb\u5e76\u5bc6\u5207\u76d1\u6d4b\uff3b31-32\uff3d\u3002\u514d\u75ab\u7cfb\u7edf\u75be\u75c5\uff0c\u5982\u7cfb\u7edf\u6027\u7ea2\u6591\u72fc\u75ae\u3001\u672a\u5206\u5316\u7ed3\u7f14\u7ec4\u7ec7\u75c5\u7b49\uff0c\u6613\u5e76\u53d1\u80ba\u52a8\u8109\u9ad8\u538b\u3001\u5fc3\u8840\u7ba1\u75be\u75c5\uff0c\u4e25\u91cd\u5371\u5bb3\u6bcd\u513f\u5b89\u5168\uff0c\u9700\u4e0e\u98ce\u6e7f\u514d\u75ab\u79d1\u8054\u5408\u8bca\u6cbb\uff3b33\uff3d\u3002\u7532\u72b6\u817a\u75be\u75c5\uff0c\u5c24\u5176\u662f\u7532\u72b6\u817a\u529f\u80fd\u4ea2\u8fdb\uff0c\u53ca\u65f6\u68c0\u67e5\u662f\u5426\u5408\u5e76\u7532\u4ea2\u6027\u5fc3\u810f\u75c5\uff3b34\uff3d\uff1b\u5b55\u4ea7\u5987\u7626\u5f31\u3001\u5c24\u5176\u662f\u4f53\u5916\u53d7\u7cbe-\u80da\u80ce\u79fb\u690d\uff08IVF-ET\uff09\u8005\uff0c\u5b55\u4ea7\u671f\u6301\u7eed\u3001\u53cd\u590d\u53d1\u70ed\u5e94\u53ca\u65f6\u6392\u67e5\uff0c\u8b66\u60d5\u7ed3\u6838\u75c5\u3002<\/p>\n
3<\/p>\n
\u4f53\u5f81<\/p>\n
\u5371\u91cd\u60a3\u8005\u65e9\u8bc6\u522b\u3001\u65e9\u91cd\u89c6\u3001\u65e9\u62a2\u6551\u3001\u65e9\u544a\u77e5\u662f\u63d0\u9ad8\u62a2\u6551\u6210\u529f\u7387\u5173\u952e\uff1b\u5371\u91cd\u5b55\u4ea7\u5987\u9884\u8b66\u6307\u6807\u53c2\u8003\u56fd\u5185\u5916\u5371\u91cd\u5b55\u4ea7\u5987\u65e9\u671f\u9884\u8b66\u7cfb\u7edf\u4e2d\u7684\u76f8\u5173\u53c2\u6570\uff0c\u63a5\u8bca\u5b55\u4ea7\u5987\u5fc5\u987b\u5feb\u901f\u8bc6\u522b\u4ee5\u4e0b\u4e3b\u8981\u751f\u547d\u4f53\u5f81\uff08\u8bc1\u636e\u7b49\u7ea72A\uff0cB\u7c7b\u63a8\u8350\uff09\uff3b35-36\uff3d\u3002<\/p>\n
3.1 \u4f53\u6e29 \u53d1\u70ed\u548c\u4f4e\u4f53\u6e29\uff08\uff1c35\u2103\uff09\u662f\u611f\u67d3\u7684\u4e24\u79cd\u8868\u73b0\uff0c\u53d1\u70ed\u88ab\u8ba4\u4e3a\u662f\u5bf9\u4eba\u4f53\u6709\u5229\u7684\u53cd\u5e94\uff0c\u4f4e\u4f53\u6e29\u4e0e\u75c5\u6b7b\u7387\u589e\u52a0\u76f8\u5173\uff0c\u7ea69%\uff5e35%\u7684\u611f\u67d3\u60a3\u8005\u4f1a\u5e76\u53d1\u4f4e\u4f53\u6e29\u8868\u73b0\uff3b37\uff3d\u3002\u5b55\u4ea7\u5987\u4f53\u6e29\u5347\u9ad8\u53ef\u80fd\u5b58\u5728\u611f\u67d3\u3001\u5e94\u6fc0\u7b49\u56e0\u7d20\uff0c\u9ad8\u70ed\u524d\u5bd2\u6218\u63d0\u793a\u6709\u7ec6\u83cc\u6216\u6bd2\u7d20\u5438\u6536\u5165\u8840\u3002\u53d1\u70ed\u4e0d\u662f\u8bca\u65ad\u8113\u6bd2\u75c7\u7684\u5fc5\u8981\u6761\u4ef6\uff0c\u4f46\u4f53\u6e29\u5f02\u5e38\u4f34\u5668\u5b98\u529f\u80fd\u635f\u5bb3\u8981\u8003\u8651\u8113\u6bd2\u75c7\u3002\u7591\u8bca\u8113\u6bd2\u75c7\uff0c\u4f7f\u7528\u4ea7\u79d1\u6539\u826f\u5f0f\u5feb\u901fSOFA\u8bc4\u5206\uff08Obstetrically modified quick SOFA score\uff0comqSOFA\uff09\u8fdb\u884c\u521d\u7b5b\uff08\u89c1\u88682\uff09\u3002\u82e5omqSOFA\u8bc4\u5206\u22652\u65f6\u8003\u8651\u8113\u6bd2\u75c7\uff0c\u5e94\u8fdb\u4e00\u6b65\u5bf9\u591a\u5668\u5b98\u529f\u80fd\u8fdb\u884c\u8bc4\u4f30\uff0c\u5373\u4ea7\u79d1\u6539\u826f\u5f0fSOFA \u8bc4\u5206\uff08Obstetrically modified SOFA score\uff0comSOFA\uff09\uff08\u89c1\u88683\uff09\uff3b38\uff3d\u3002\u8113\u6bd2\u75c7\u60a3\u8005\u7684\u6cbb\u7597\u662f\u533b\u7597\u7d27\u6025\u4e8b\u4ef6\uff0c1h\u5185\uff08\u9ec4\u91d11h\uff09\u5fc5\u987b\u540c\u65f6\u5b8c\u6210\u4e73\u9178\u6c34\u5e73\u68c0\u6d4b\u3001\u7559\u53d6\u8840\u57f9\u517b\uff08\u4f7f\u7528\u6297\u751f\u7d20\u524d\uff09\u3001\u5e7f\u8c31\u6297\u751f\u7d20\u4f7f\u7528\u3001\u9759\u8109\u6db2\u4f53\u590d\u82cf\u3001\u8840\u7ba1\u6d3b\u6027\u836f\u7269\uff0c\u5e76\u5728\u590d\u82cf\u65e9\u671f\u8fdb\u884c\u6bcf\u5c0f\u65f6\u8bc4\u4f30\uff3b39\uff3d\u3002<\/p>\n<\/p>\n
3.2 \u5fc3\u7387 \u968f\u5b55\u5468\u589e\u52a0\uff0c\u6bcd\u4f53\u8840\u5bb9\u91cf\u9010\u6e10\u589e\u52a0\uff0c\u598a\u5a2032\uff5e34\u5468\u65f6\u5fc3\u7387\u8fbe\u9ad8\u5cf0\uff3b40\uff3d\uff0c\u5fc3\u7387\u6301\u7eed\uff1e110\u6b21\/min\uff08\u9884\u8b66\uff09\uff3b41\uff3d\uff0c\u53ef\u89c1\u4e8e\u53d1\u70ed\u3001\u5fc3\u529f\u80fd\u4e0d\u5168\u3001\u4f11\u514b\u3001\u7532\u72b6\u817a\u529f\u80fd\u4ea2\u8fdb\u3001\u8d2b\u8840\u3001\u4f4e\u6c27\u8840\u75c7\u7b49\u3002\u5fc3\u7387\u226450\u6b21\/min\u591a\u4e3a\u75c5\u7406\u6027\uff08\u8fd0\u52a8\u5458\u9664\u5916\uff09\uff0c\u5f53\u4f34\u6709\u8840\u538b\u4e0b\u964d\u6216\u9891\u53d1\u5ba4\u6027\u5fc3\u5f8b\u5931\u5e38\u9700\u8981\u5fc3\u5185\u79d1\u53ca\u65f6\u8bca\u6cbb\u3002<\/p>\n
\u598a\u5a20\u60a3\u8005\u4e2d\u6700\u5e38\u89c1\u7684\u5ba4\u4e0a\u6027\u5fc3\u5f8b\u5931\u5e38\uff0c\u4e00\u822c\u4e3a\u826f\u6027\uff0c\u5305\u62ec\u7aa6\u6027\u5fc3\u5f8b\u5931\u5e38\u3001\u5ba4\u4e0a\u6027\u5fc3\u52a8\u8fc7\u901f\u3001\u65e9\u640f\u7b49\u3002\u5fc3\u5f8b\u5931\u5e38\u5408\u5e76\u663e\u8457\u8840\u6d41\u52a8\u529b\u5b66\u5f02\u5e38\uff0c\u5e94\u53ca\u65f6\u4f7f\u7528\u6709\u6548\u6cbb\u7597\u65b9\u6cd5\uff08\u5982\u5fc3\u810f\u590d\u5f8b\u3001\u4f7f\u7528\u6297\u5fc3\u5f8b\u5931\u5e38\u836f\u7269\u6216\u5bfc\u7ba1\u6d88\u878d\u7b49\uff09\uff3b42\uff3d\u3002\u5b55\u4ea7\u5987\u5408\u5e76\u5fc3\u810f\u75be\u75c5\u9700\u6ce8\u610f\u76d1\u6d4b\u8840\u94be\uff0c\u4f4e\u8840\u94be\u6613\u8bf1\u53d1\u6076\u6027\u5fc3\u5f8b\u5931\u5e38\u3002 <\/p>\n
3.3 \u547c\u5438 \u547c\u5438\u5f02\u5e38\u5305\u62ec\u547c\u5438\u9891\u7387\u3001\u8282\u5f8b\u3001\u6df1\u5ea6\u3001\u547c\u5438\u58f0\u97f3\u5f02\u5e38\uff0c\u662f\u5426\u5b58\u5728\u547c\u5438\u56f0\u96be\u7b49\uff0c\u662f\u6025\u5371\u91cd\u75c7\u65e9\u671f\u9884\u8b66\u4e2d\u6700\u654f\u611f\u4e14\u5177\u6709\u4ef7\u503c\u7684\u6307\u6807\u3002\u5b55\u4ea7\u5987\u6613\u60a3\u6025\u6027\u80ba\u6c34\u80bf\u3001\u6025\u6027\u547c\u5438\u7a98\u8feb\u7efc\u5408\u5f81\uff08ARDS\uff09\u7b49\u4f4e\u6c27\u8840\u75c7\uff1b\u7ecf\u547c\u5438\u9053\u4f20\u64ad\u7684\u75c5\u6bd2\u611f\u67d3\u75be\u75c5\u8f83\u5e38\u89c1\u3002\u5b55\u4ea7\u5987\u9759\u606f\u72b6\u6001\u4e0b\u547c\u5438\u9891\u7387\uff1e24\u6b21\/min\uff08\u9884\u8b66\uff09\uff0c\u63d0\u793a\u673a\u4f53\u5df2\u542f\u52a8\u547c\u5438\u4ee3\u507f\u673a\u5236\uff3b41\uff3d\u3002\u547c\u5438\u9891\u7387\u51cf\u6162\uff1c10\u6b21\/min\uff08\u9884\u8b66\uff09\u591a\u89c1\u4e8e\u4ee3\u8c22\u6027\u75be\u75c5\u3001\u4e2d\u67a2\u75c5\u53d8\u3001\u4e25\u91cd\u547c\u5438\u6291\u5236\u7b49\uff0c\u5c24\u5176\u8981\u5173\u6ce8\u9ad8\u9541\u8840\u75c7\u5bfc\u81f4\u547c\u5438\u808c\u65e0\u529b\u548c\u4e2d\u67a2\u6291\u5236\u72b6\u6001\uff0c\u751a\u81f3\u547c\u5438\u505c\u6b62\uff1b\u53f9\u606f\u6837\u547c\u5438\u662f\u547c\u5438\u5fc3\u8df3\u505c\u6b62\u7684\u4fe1\u53f7\uff3b43\uff3d\u3002<\/p>\n
\u8840\u6c27\u9971\u548c\u5ea6\uff08SpO2\uff09\u53cd\u6620\u8840\u6db2\u643a\u5e26\u8f93\u9001\u6c27\u6c14\u7684\u80fd\u529b\uff0c\u6b63\u5e38\u4eba\u4f53\u52a8\u8109\u8840\u7684SpO2\uff1e0.95\uff0c0.90~0.94\u8868\u793a\u673a\u4f53\u8840\u6c27\u542b\u91cf\u4e0b\u964d\u3002\u5b55\u4ea7\u5987\u6c27\u9971\u548c\u5ea6\uff1c0.92\uff08\u9884\u8b66\uff09\u63d0\u793a\u673a\u4f53\u660e\u663e\u7f3a\u6c27\uff3b41\uff3d\u3002\u4f4e\u6c27\u8840\u75c7\u6807\u51c6\u4e3a\u6807\u51c6\u5927\u6c14\u538b\u4e0b\u52a8\u8109\u8840\u6c27\u5206\u538b\uff08PaO2\uff09\uff1c60mmHg\u3001\u7ecf\u76ae\u8840\u6c27\u9971\u548c\u5ea6\uff1c0.90\uff0c\u4f4e\u6c27\u65f6\u53ef\u51fa\u73b0\u5934\u6655\u3001\u5934\u75db\uff0c\u80f8\u95f7\u3001\u547c\u5438\u56f0\u96be\uff0c\u4e25\u91cd\u65f6\u795e\u5fd7\u4e27\u5931\u751a\u81f3\u660f\u8ff7\u3002\u53d1\u751f\u4f4e\u6c27\u8840\u75c7\u65f6\u7684\u5438\u6c27\u63a8\u8350\u76ee\u6807SpO2\u4e3a0.94~0.98\u3002\u5438\u6c27\u6d53\u5ea6\u8d85\u8fc75L\/min\u65f6\u9700\u9762\u7f69\u5438\u6c27\uff0cSpO2\u4ecd\u65e0\u6709\u6548\u6539\u5584\u9700\u8fc5\u901f\u542f\u52a8\u6025\u6551\u53ca\u591a\u5b66\u79d1\u4f1a\u8bca\uff0c\u7d27\u6025\u60c5\u51b5\u4e0b\u9700\u53ca\u65f6\u8bc4\u4f30\u884c\u6c14\u7ba1\u63d2\u7ba1\u7b49\u5efa\u7acb\u4eba\u5de5\u6c14\u9053\uff0c\u5e76\u91c7\u7528\u4eba\u5de5\u6c14\u56ca\u6216\u673a\u68b0\u901a\u6c14\u62a2\u6551\u6cbb\u7597\u3002\u82e5\u5fc3\u7387\u3001\u547c\u5438\u9891\u7387\u3001SpO2\u7a33\u5b9a\uff0c\u53ef\u914c\u60c5\u590d\u67e5\u8840\u6c14\uff0c\u9010\u6e10\u964d\u4f4e\u5438\u6c27\u6d53\u5ea6\u76f4\u81f3\u505c\u6b62\u6c27\u7597\uff3b44\uff3d\u3002<\/p>\n
3.4 \u8840\u538b \u51c6\u786e\u6d4b\u91cf\u8840\u538b\uff0c\u5feb\u901f\u5224\u65ad\u662f\u4e34\u5e8a\u8bca\u6cbb\u5371\u6025\u91cd\u75c7\u7684\u5173\u952e\u3002\u8840\u538b\u6b63\u5e38\u9ad8\u503c\u4e3a\uff1a130\uff5e139\/80\uff5e89mmHg\uff0c\u9ad8\u8840\u538b\u5b9a\u4e49\u4e3a\u8840\u538b\u2265140\/90mmHg\u3002\u4ea7\u524d\u3001\u4ea7\u65f6\u53ca\u4ea7\u540e\u968f\u65f6\u53ef\u80fd\u51fa\u73b0\u8840\u538b\u5347\u9ad8\uff0c\u53d1\u5c55\u4e3a\u5b50\u75eb\u524d\u671f\uff0c\u5f53\u6536\u7f29\u538b\u2265160mmHg\u548c\uff08\u6216\uff09\u8212\u5f20\u538b\u2265110mmHg\uff08\u91cd\u5ea6\u9ad8\u8840\u538b\uff09\uff08\u9884\u8b66\uff09\uff0c\u5fc5\u987b\u8fc5\u901f\u4e88\u4ee5\u964d\u538b\u6cbb\u7597\uff0c\u907f\u514d\u9ad8\u8840\u538b\u5371\u8c61\u3001\u8111\u5352\u4e2d\u3001\u5b50\u75eb\u7b49\u4e25\u91cd\u5e76\u53d1\u75c7\uff3b45\uff3d\u3002<\/p>\n
\u51b3\u5b9a\u8111\u548c\u80be\u704c\u6ce8\u7684\u91cd\u8981\u6307\u6807\u662f\u5e73\u5747\u52a8\u8109\u538b\uff3b\uff08\u6536\u7f29\u538b+2\u00d7\u8212\u5f20\u538b\uff09\/3\uff3d\uff0c\u901a\u5e38\uff1e70mmHg\uff0c\u9884\u8b66\u6307\u6807\u4e3a\u5e73\u5747\u52a8\u8109\u538b\uff1c65mmHg\u3002\u8840\u538b\uff1c90\/50mmHg\uff0c\u8003\u8651\u4f4e\u8840\u538b\uff0c\u4e0e\u4e0d\u826f\u598a\u5a20\u7ed3\u5c40\u5173\u7cfb\u4e0d\u786e\u5b9a\u3002\u4f4e\u8840\u538b\u5408\u5e76\u56db\u80a2\u6e7f\u51b7\u3001\u5fc3\u7387\u52a0\u5feb\u3001\u8109\u538b\u7f29\u5c0f\u3001\u5c11\u5c3f\u3001\u795e\u5fd7\u6539\u53d8\u53ca\u7ec4\u7ec7\u704c\u6ce8\u6307\u6807\uff08\u5982\u8840\u4e73\u9178\u7b49\uff09\u5f02\u5e38\uff0c\u63d0\u793a\u51fa\u73b0\u4f11\u514b\uff0c\u4f46\u4f4e\u8840\u538b\u5e76\u975e\u662f\u4f11\u514b\u8bca\u65ad\u7684\u5fc5\u8981\u6761\u4ef6\uff0c\u5bf9\u4e8e\u539f\u6709\u9ad8\u8840\u538b\u8005\u6536\u7f29\u538b\u81ea\u57fa\u7ebf\u4e0b\u964d40mmHg\u5e94\u8003\u8651\u4f11\u514b\u53ef\u80fd\uff08\u9884\u8b66\uff09\u5e76\u65e9\u671f\u5e72\u9884\uff3b41\uff0c46-47\uff3d\u3002<\/p>\n
3.5 \u795e\u5fd7 \u5b55\u4ea7\u5987\u610f\u8bc6\u72b6\u6001\u5f02\u5e38\u8868\u660e\u4ee3\u507f\u673a\u5236\u8017\u7aed\u6216\u4e25\u91cd\u7684\u795e\u7ecf\u7cfb\u7edf\u75be\u75c5\uff1b\u70e6\u8e81\u3001\u7d27\u5f20\u4e0d\u5b89\uff0c\u63d0\u793a\u4f11\u514b\u65e9\u671f\uff08\u9884\u8b66\uff09\uff1b\u55dc\u7761\u3001\u610f\u8bc6\u6a21\u7cca\u8bf4\u660e\u5373\u5c06\u53d1\u751f\u660f\u8ff7\u3002\u4e25\u91cd\u611f\u67d3\uff0c\u7535\u89e3\u8d28\u3001\u9178\u78b1\u5e73\u8861\u7d0a\u4e71\uff0c\u8111\u8840\u7ba1\u75c5\u3001\u809d\u6027\u8111\u75c5\u3001\u5c3f\u6bd2\u75c7\u3001\u9152\u7cbe\u6212\u65ad\u3001\u80f0\u6027\u8111\u75c5\u7b49\u5747\u53ef\u51fa\u73b0\u610f\u8bc6\u969c\u788d\uff0c\u5e94\u53c2\u8003 Glasgow\uff08\u683c\u62c9\u65af\u54e5\uff09\u660f\u8ff7\u8bc4\u5206\uff08\u89c1\u88684\uff09\uff3b48-49\uff3d\uff0c\u5b9e\u65bd\u52a8\u6001\u8bc4\u4f30\uff08\u8bc1\u636e\u7b49\u7ea72A\uff0cB\u7c7b\u63a8\u8350\uff09\u3002<\/p>\n<\/p>\n
3.6 \u5c3f\u91cf \u5c3f\u91cf\u662f\u5faa\u73af\u53d8\u5316\u7684\u201c\u54e8\u5175\u201d\u3002\u795e\u5fd7\u53d8\u5316\u3001\u5c3f\u91cf\u51cf\u5c11\u53ca\u76ae\u80a4\u82cd\u767d\u79f0\u4e3a\u4f11\u514b\u65e9\u671f\u7684\u201c\u7a97\u53e3\u201d\u3002\u5c3f\u6db2\u4e00\u822c\u5448\u6de1\u9ec4\u8272\uff0c\u5173\u6ce8\u5c3f\u6db2\u989c\u8272\u53d8\u5316\u6709\u52a9\u4e8e\u8bc4\u4f30\u53ca\u9884\u8b66\uff0c\u5982\u8840\u5c3f\u53ca\u9171\u6cb9\u8272\u5c3f\uff08\u8b66\u60d5\u6eb6\u8840\uff09\u3002\u89c2\u5bdf\u3001\u8bb0\u5f55\u5c3f\u91cf\u3001\u7279\u522b\u662f\u5b9a\u671f\u8bc4\u4f30\u6bcf\u5c0f\u65f6\u5c3f\u91cf\u5bf9\u4e34\u5e8a\u5224\u65ad\u4f11\u514b\u7b49\u5faa\u73af\u53d8\u5316\u6709\u91cd\u8981\u4ef7\u503c\uff0c\u5c3f\u91cf\uff1c0.5mL\/\uff08kg\u00b7h\uff09\u6301\u7eed2h\u63d0\u793a\u9884\u8b66\uff3b41\uff3d\u3002\u89c1\u88685\u3002<\/p>\n<\/p>\n
3.7 \u76ae\u80a4\u9ecf\u819c \u76ae\u80a4\u9ecf\u819c\u989c\u8272\u53ca\u6e29\u5ea6\u53cd\u6620\u5916\u5468\u704c\u6ce8\uff08\u89c1\u88686\uff09\u3002\u76ae\u80a4\u82cd\u767d\u3001\u56db\u80a2\u6e7f\u51b7\u63d0\u793a\u53ef\u80fd\u4f11\u514b\uff0c\u76ae\u80a4\u51fa\u8840\u503e\u5411\u5e38\u89c1\u51dd\u8840\u529f\u80fd\u5f02\u5e38\u548c\uff08\u6216\uff09\u8840\u5c0f\u677f\u51cf\u5c11\u3002<\/p>\n<\/p>\n
4<\/p>\n
\u5b9e\u9a8c\u5ba4\u68c0\u67e5<\/p>\n
\u5371\u6025\u503c\u6307\u5371\u53ca\u751f\u547d\u5b89\u5168\u7684\u68c0\u9a8c\u7ed3\u679c\uff3b50\uff3d\u30022007\u5e74\u59cb\u56fd\u5bb6\u536b\u751f\u5065\u5eb7\u59d4\u5458\u4f1a\u5c06\u5371\u6025\u503c\u62a5\u544a\u5217\u5165\u60a3\u8005\u5b89\u5168\u76ee\u6807\uff0c\u8981\u6c42\u533b\u7597\u673a\u6784\u5236\u5b9a\u9002\u5408\u672c\u5355\u4f4d\u7684\u5371\u6025\u503c\u9879\u76ee\u548c\u62a5\u544a\u5236\u5ea6\u3002\u6839\u636e\u201c\u4e2d\u56fd\u533b\u9662\u534f\u4f1a\u60a3\u8005\u5b89\u5168\u76ee\u6807\u201d\u7684\u89c4\u5b9a\u81f3\u5c11\u4f46\u4e0d\u9650\u4e8e\u4ee5\u4e0b\u6307\u6807\uff1a\u8840\u9499\u3001\u8840\u94be\u3001\u8840\u6c14\u3001\u767d\u7ec6\u80de\u8ba1\u6570\u3001\u8840\u5c0f\u677f\u8ba1\u6570\u3001\u51dd\u8840\u9176\u539f\u65f6\u95f4\u3001\u6d3b\u5316\u90e8\u5206\u51dd\u8840\u6d3b\u9176\u65f6\u95f4\uff3b51\uff3d\u3002\u53d1\u73b0\u5371\u6025\u503c\u7acb\u5373\u62a5\u544a\u7ed9\u4e34\u5e8a\u79d1\u5ba4\uff0830min\u4ee5\u5185\uff09\u5e76\u53ca\u65f6\u5904\u7406\uff3b52\uff3d\u3002\u4e00\u822c\u5728\u51fa\u73b0\u5371\u6025\u503c\u65f6\u9884\u793a\u75c5\u60c5\u5411\u4e25\u91cd\u7a0b\u5ea6\u8f6c\u5316\uff1b\u5371\u6025\u503c\u8bc6\u522b\u8d8a\u65e9\uff0c\u4e34\u5e8a\u5e94\u7528\u4ef7\u503c\u5c31\u8d8a\u5927\uff3b53\uff3d\u3002\u89c1\u88687\u3002\u76ee\u524d\u56fd\u5185\u5916\u5c1a\u65e0\u5b55\u4ea7\u5987\u7279\u6709\u7684\u5371\u6025\u503c\uff0c\u4e3b\u8981\u53c2\u8003\u666e\u901a\u60a3\u8005\u5371\u6025\u503c\u53ca\u5904\u7406\u6d41\u7a0b\uff1b\u4f46\u5b55\u4ea7\u671f\u8fbe\u5230\u5371\u6025\u503c\u65f6\u75c5\u60c5\u53ef\u80fd\u66f4\u52a0\u4e25\u91cd\uff0c\u4e3a\u65e9\u671f\u8bc6\u522b\u3001\u65e9\u671f\u5e72\u9884\uff0c\u5fc5\u987b\u5bf9\u5b55\u4ea7\u5987\u5173\u952e\u6307\u6807\u65e9\u671f\u5f02\u5e38\u53ca\u65f6\u5173\u6ce8\u3001\u53ca\u65f6\u5e72\u9884\u3001\u52a8\u6001\u8bc4\u4f30\u3002<\/p>\n
4.1 \u8840\u5e38\u89c4 \u598a\u5a20\u671f\u767d\u7ec6\u80de\u8ba1\u6570\u8f7b\u5ea6\u589e\u52a0\uff0c\u4e00\u822c\uff085\uff5e12\uff09\u00d7109\/L\uff0c\u6709\u65f6\u53ef\u8fbe15\u00d7109\/L\u3002\u4e34\u4ea7\u548c\u4ea7\u8925\u671f\u767d\u7ec6\u80de\u8ba1\u6570\u663e\u8457\u589e\u52a0\uff0c\u4e00\u822c\uff0814\uff5e16\uff09\u00d7109\/L\uff0c\u6709\u65f6\u53ef\u8fbe30\u00d7109\/L\u3002\u4ea7\u540e1\uff5e2\u5468\u5185\u767d\u7ec6\u80de\u6c34\u5e73\u53ef\u6062\u590d\u81f3\u6b63\u5e38\uff3b40\uff3d\u3002\u8840\u5e38\u89c4\u4e2d\u201c\u4e09\u7cfb\u201d\u51cf\u5c11\u53ef\u80fd\u4e3a\u518d\u751f\u969c\u788d\u6027\u8d2b\u8840\u3002\u56fd\u5bb6\u6807\u51c6\u4e3a\u5f53\u8840\u7ea2\u86cb\u767d\uff1c70g\/L\uff0c\u5efa\u8bae\u8f93\u8840\u3002\u5b55\u4ea7\u5987\u8840\u7ea2\u86cb\u767d\u6c34\u5e73\uff1c50g\/L\u6216\u8840\u5c0f\u677f\uff1c50\u00d7109\/L\u65f6\uff0c\u4e25 \u91cd \u4e34 \u5e8a \u4e0d \u826f \u9884 \u540e \u7684 \u98ce \u9669 \u663e \u8457 \u589e \u9ad8\uff08\u8bc1\u636e\u7b49\u7ea71B\uff0cA\u7c7b\u63a8\u8350\uff09\uff3b54\uff3d\u3002\u5b55\u671f\u53d1\u751f\u8840\u5c0f\u677f\u589e\u591a\u75c7\uff0c\u5bb9\u6613\u51fa\u73b0\u4e25\u91cd\u7684\u8840\u6813\u6027\u75be\u75c5\u3002\u8840\u5c0f\u677f\u964d\u4f4e\u4f34\u6709\u8d2b\u8840\u65f6\u5e94\u8b66\u60d5\u8840\u6813\u6027\u5fae\u8840\u7ba1\u75c5\uff08thrombotic microangiopathy\uff0cTMA\uff09\uff0c\u8be5\u75c5\u75c5\u6b7b\u7387\u9ad8\uff0c\u5916\u5468\u8840\u56fe\u7247\u53d1\u73b0\u7834\u788e\u7ea2\u7ec6\u80de\uff1e1%\u5bf9TMA\u8bca\u65ad\u6709\u4e34\u5e8a\u610f\u4e49\uff3b55\uff3d\u3002<\/p>\n
4.2 \u51dd\u8840\u529f\u80fd\u53ca\u8840\u6813\u5f39\u529b\u56fe \u598a\u5a20\u671f\u8840\u6db2\u5904\u4e8e\u9ad8\u51dd\u72b6\u6001\uff0c\u51dd\u8840\u9176\u539f\u65f6\u95f4\uff08PT\uff09\u53ca\u6d3b\u5316\u90e8\u5206\u51dd\u8840\u6d3b\u9176\u65f6\u95f4\uff08APTT\uff09\u8f7b\u5ea6\u7f29\u77ed\uff0c\u4ea7\u540e\u51fa\u8840\u6551\u6cbb\u76ee\u6807\u662f\u7ef4\u6301PT\u53caAPTT\u5747\uff1c1.5\u500d\u5e73\u5747\u503c\u3002\u5b55\u671f\u8840\u6d46\u7ea4\u7ef4\u86cb\u767d\u539f\uff08Fib\uff09\u662f\u9700\u4e25\u5bc6\u89c2\u5bdf\u7684\u91cd\u8981\u6307\u6807\uff0c\u5176\u542b\u91cf\u968f\u5b55\u5468\u589e\u5927\u800c\u589e\u52a0\uff0c\u6bd4\u975e\u5b55\u671f\u7ea6\u589e\u52a050%\uff0c\u598a\u5a20\u672b\u671f\u5e73\u5747\u503c\u4e3aFib 4.5g\/L\uff08\u975e\u5b55\u5987\u5973\u5e73\u5747\u4e3a3g\/L\uff09\uff3b40\uff0c56-58\uff3d\uff1b\u5b55\u671f\u53d1\u73b0Fib\u4f4e\u4e8e\u6b63\u5e38\u503c\u9700\u9ad8\u5ea6\u8b66\u60d5\u4e0e\u4e25\u91cd\u809d\u810f\u75be\u75c5\u76f8\u5173\uff0c\u9664\u6392\u67e5\u5c11\u89c1\u7684\u5148\u5929\u6027\u7ea4\u7ef4\u86cb\u767d\u539f\u7f3a\u4e4f\u75c7\u5916\uff0c\u9700\u5bc6\u5207\u5173\u6ce8\u5bf9\u51dd\u8840\u529f\u80fd\u7684\u5f71\u54cd\uff1b\u5b55\u5987\u7591\u8bca\u598a\u5a20\u6025\u6027\u8102\u80aa\u809d\uff0c\u51dd\u8840\u529f\u80fd\u4e3a\u95e8\u8bca\u7b5b\u67e5\u7684\u4e00\u7ebf\u6307\u6807\uff08\u8bc1\u636e\u7b49\u7ea71C\uff0cA\u7c7b\u63a8\u8350\uff09\uff3b59\uff3d\u3002\u4ea7\u540e\u51fa\u8840\u6551\u6cbb\u91cd\u8981\u76d1\u6d4b\u6307\u6807\u4e4b\u4e00\u662f\u5fc5\u987b\u7ef4\u6301\u60a3\u8005\u7ea4\u7ef4\u86cb\u767d\u539f\u22652g\/L\uff0c\u5426\u5219\u6613\u53d1\u751f\u81ea\u53d1\u6027\u51fa\u8840\uff3b60-61\uff3d\u3002\u968f\u7740\u5b55\u5468\u589e\u52a0D-\u4e8c\u805a\u4f53\u6c34\u5e73\u9010\u6e10\u4e0a\u5347\uff0c\u5728\u5b55\u665a\u671f\u8fbe\u5230\u5cf0\u503c\u3002\u4e0d\u63a8\u8350D-\u4e8c\u805a\u4f53\u4f5c\u4e3a\u4ea7\u5987VTE\u7b5b\u67e5\u3001\u8bca\u65ad\u3001\u9884\u9632\u6216\u6cbb\u7597\u7684\u53c2\u8003\u6307\u6807\uff1b\u8840\u6d46D-\u4e8c\u805a\u4f53\uff1c0.5mg\/L\u53ef\u4f5c\u4e3a\u6392\u9664\u8840\u6813\u7684\u754c\u503c\uff3b62\uff3d\u3002<\/p>\n
\u8840\u6813\u5f39\u529b\u56fe\uff08TEG\uff09\u80fd\u4ece\u6574\u4f53\u4e0a\u52a8\u6001\u53cd\u6620\u51dd\u8840\u548c\u7ea4\u6eb6\u8fc7\u7a0b\uff0c\u80fd\u5bf9\u8840\u51dd\u5757\u5f62\u6210\u7684\u901f\u5ea6\u3001\u5f3a\u5ea6\u3001\u7a33\u5b9a\u6027\u53ca\u51dd\u8840\u56e0\u5b50\u5c24\u5176\u662f\u7ea4\u7ef4\u86cb\u767d\u539f\u3001\u8840\u5c0f\u677f\u6570\u91cf\u548c\u529f\u80fd\u3001\u7ea4\u7ef4\u86cb\u767d\u6eb6\u89e3\u7b49\u8fdb\u884c\u5168\u9762\u8bc4\u4f30\u3002\u5bf9\u4e8e\u4ea7\u540e\u51fa\u8840\u3001\u598a\u5a20\u671f\u8840\u5c0f\u677f\u51cf\u5c11\u3001HELLP\u7efc\u5408\u5f81\u7b49\u51dd\u8840\u56e0\u5b50\u5f02\u5e38\u505a\u51fa\u5224\u65ad\uff08\u8bc1\u636e\u7b49\u7ea72A\uff0cB\u7c7b\u63a8\u8350\uff09\uff3b63\uff3d\uff0c\u6307\u5bfc\u6210\u5206\u8f93\u8840\uff0c\u8c03\u6574\u7528\u836f\uff08\u8bc1\u636e\u7b49\u7ea71A\uff0c\uff21\u7c7b\u63a8\u8350\uff09\uff3b64-66\uff3d\u7b49\u4e00\u7cfb\u5217\u4e0e\u51dd\u8840\u529f\u80fd\u6709\u5173\u7684\u8bca\u7597\u3002\u89c1\u88688\u3002<\/p>\n
4.3 \u8840\u6c14\u5206\u6790 \u8840\u6c14\u5206\u6790\u5bf9\u4e8e\u8bc4\u4f30\u547c\u5438\u3001\u5faa\u73af\u3001\u9178\u78b1\u5e73\u8861\u53ca\u7535\u89e3\u8d28\u7b49\u5185\u73af\u5883\u5177\u6709\u91cd\u8981\u610f\u4e49\uff0c\u5e94\u53ca\u65e9\u68c0\u67e5\u3002\uff081\uff09pH\uff1c7.35\uff0c\u63d0\u793a\u7ec4\u7ec7\u704c\u6ce8\u5f02\u5e38\uff0cPaCO2\u5c0f\u4e8e35mmHg\u6216pH\uff1e7.45\uff0c\u63d0\u793a\u6709\u547c\u5438\u8870\u7aed\u6216\u8fc7\u5ea6\u901a\u6c14\u3002\uff082\uff09\u52a8\u8109\u8840\u4e73\u9178\uff08Lac\uff09\u662f\u53cd\u5e94\u5fae\u5faa\u73af\u7f3a\u8840\u7f3a\u6c27\u6700\u654f\u611f\u7684\u6307\u6807\uff0c\u4e73\u9178\u6c34\u5e73\uff1e2.0mmol\/L\u8bca\u65ad\u4e3a\u9ad8\u4e73\u9178\u8840\u75c7\uff0c\u662f\u75c5\u60c5\u5371\u91cd\u7684\u72ec\u7acb\u6307\u6807\uff3b68-69\uff3d\uff0c\u5f53\u4e73\u9178\uff1e4.0mmol\/L\u65f6\uff0c\u901a\u5e38\u4f34\u6709pH\u503c\u22647.35\u8bca\u65ad\u4e3a\u4e73\u9178\u9178\u4e2d\u6bd2\uff0c\u60a3\u8005\u4f1a\u51fa\u73b0\u547c\u5438\u56f0\u96be\u3001\u4f4e\u8840\u538b\u3001\u660f\u8ff7\u3001\u795e\u5fd7\u6a21\u7cca\u3001\u4f53\u6e29\u4e0b\u964d\uff0c\u751a\u81f3\u4f1a\u53d1\u751f\u4f11\u514b\u548c\u6b7b\u4ea1\uff3b70\uff3d\uff0c\u8113\u6bd2\u75c7\u8840\u4e73\u9178\uff1e4.0mmol\/L\u65f6\uff0c\u75c5\u6b7b\u7387\u53ef\u4ee5\u8fbe\u523080%\u3002<\/p>\n
\u4e0e\u7ec4\u7ec7\u4f4e\u6c27\u76f8\u5173\u7684\u9ad8\u4e73\u9178\u8840\u75c7\uff0c\u5982\u51fa\u73b0\u4f11\u514b\u3001\u5fc3\u8870\u3001\u8113\u6bd2\u75c7\u65f6\uff0cLac\uff1e4.0mmol\/L\u987b\u7acb\u5373\u62a2\u6551\u3002\u4e73\u9178\u52a8\u6001\u53d8\u5316\u53ca\u4e73\u9178\u6e05\u9664\u7387\u589e\u52a0\u5bf9\u4e8e\u8bc4\u4f30\u75c5\u60c5\u5177\u6709\u51b3\u5b9a\u610f\u4e49\uff08\u8bc1\u636e\u7b49\u7ea72A\uff0cB\u7c7b\u63a8\u8350\uff09\uff3b71-73\uff3d\u3002\u4e0e\u7ec4\u7ec7\u4f4e\u6c27\u65e0\u5173\u7684\u4e73\u9178\u589e\u9ad8\u53ef\u89c1\u4e8e\u7cd6\u5c3f\u75c5\u3001\u6076\u6027\u80bf\u7624\u3001\u809d\u75c5\u7b49\uff1b\u5267\u70c8\u8fd0\u52a8\u65f6\u8eab\u4f53\u808c\u8089\u4e25\u91cd\u6536\u7f29\uff0c\u65e0\u6c27\u4ee3\u8c22\u589e\u52a0\uff0c\u53ef\u51fa\u73b0\u4e73\u9178\u6c34\u5e73\u660e\u663e\u5347\u9ad8\uff0c\u6570\u5c0f\u65f6\u81ea\u884c\u6062\u590d\u6b63\u5e38\uff3b74\uff3d\u3002\u9634\u9053\u5206\u5a29\u4ea7\u5987\u52a8\u8109\u8840\u4e73\u9178\u6c34\u5e73\u53ef\u80fd\u660e\u663e\u5347\u9ad8\uff0c\u5efa\u8bae\u7ed3\u5408\u4e34\u5e8a\u75c7\u72b6\u53ca\u4f53\u5f81\u52a8\u6001\u89c2\u5bdf\uff3b75\uff3d\u3002\u598a\u5a20\u671f\u6fc0\u7d20\u5f71\u54cd\u547c\u5438\u4e2d\u67a2\u6613\u51fa\u73b0\u8fc7\u5ea6\u901a\u6c14\uff0c\u5bfc\u81f4\u52a8\u8109\u53ca\u80ba\u6ce1CO2\u5206\u538b\u964d\u4f4e\uff0828\uff5e32mmHg\uff09\uff0c\u591a\u6570\u60c5\u51b5\u4e0b\u5e73\u5747PaCO2\u4e3a32mmHg\uff0cPaO2\u5347\u9ad8\u4e3a105mmHg\u3002\u89c1\u88689\u3002<\/p>\n
4.4 \u8840\u7cd6\u4e0e\u7535\u89e3\u8d28\u5f02\u5e38 \u8840\u7cd6\u5f02\u5e38\u7684\u76f8\u5173\u5b9a\u4e49\uff1a\u4f4e\u8840\u7cd6\u75c7\u662f\u6307\u7a7a\u8179\u8840\u7cd6\uff1c2.8mmol\/L\uff08\u6b63\u5e38\u6210\u4eba\uff09\u6216\u7a7a\u8179\u8840\u7cd6\uff1c3.9mmol\/L\uff08\u7cd6\u5c3f\u75c5\u60a3\u8005\uff09\uff1b\u9ad8\u8840\u7cd6\u75c7\u662f\u6307\u7a7a\u8179\u8840\u7cd6\uff1e7.0mmol\/L\uff1b\u8840\u7cd6\u660e\u663e\u589e\u9ad8\uff08\uff1e13.9mmol\/L\uff09\u5e94\u8b66\u60d5\u7cd6\u5c3f\u75c5\u916e\u75c7\u9178\u4e2d\u6bd2\uff3b76\uff3d\u3002\u6b63\u5e38\u5b55\u4ea7\u5987\u8840\u7cd6\uff1e10mmol\/L\u65f6\u9884\u8b66\uff3b41\uff3d\u3002\u89c1\u886810\u3002<\/p>\n<\/p>\n
4.5 \u809d\u529f\u80fd \u598a\u5a20\u671f3%\uff5e5%\u7684\u5b55\u5987\u53ef\u80fd\u51fa\u73b0\u809d\u529f\u80fd\u5f02\u5e38\uff0c\u539f\u56e0\u591a\u6837\uff0c\u9700\u8981\u5408\u7406\u8bc4\u4f30\u548c\u8bca\u65ad\uff3b77\uff3d\u3002\u4e19\u6c28\u9178\u8f6c\u6c28\u9176\uff08ALT\uff09\u589e\u9ad8\u63d0\u793a\u809d\u7ec6\u80de\u635f\u4f24\u3002\u5929\u51ac\u6c28\u9178\u8f6c\u6c28\u9176\uff08AST\uff09\u5347\u9ad8\uff0c\u63d0\u793a\u7ebf\u7c92\u4f53\u635f\u4f24\u3002ALT\u5bf9\u809d\u75c5\u8bca\u65ad\u7684\u7279\u5f02\u6027\u6bd4AST\u9ad8\uff0cAST\u4e0e\u809d\u75c5\u4e25\u91cd\u7a0b\u5ea6\u5448\u6b63\u76f8\u5173\u3002<\/p>\n
\u80c6\u7ea2\u7d20\u53ef\u4ee5\u53cd\u6620\u809d\u7ec6\u80de\u635f\u4f24\u4e25\u91cd\u7a0b\u5ea6\u3002\u809d\u7ec6\u80de\u5927\u91cf\u574f\u6b7b\u65f6\uff0c\u53ef\u51fa\u73b0\u8f6c\u6c28\u9176\u4e0b\u964d\u800c\u8840\u6e05\u603b\u80c6\u7ea2\u7d20\u5347\u9ad8\uff0c\u5373\u201c\u80c6\u9176\u5206\u79bb\u201d\u73b0\u8c61\u3002\u8840\u6e05\u603b\u80c6\u7ea2\u7d20\u8d85\u8fc7171\u03bcmol \/L\uff0c\u63d0\u793a\u51fa\u73b0\u809d\u529f\u80fd\u8870\u7aed\uff0c\u53ef\u89c1\u4e8e\u598a\u5a20\u671f\u6025\u6027\u8102\u80aa\u809d\u3001\u6025\u6027\u91cd\u75c7\u809d\u708e\u53caHELLP\u7efc\u5408\u5f81\u3002\u8840\u6e05\u767d\u86cb\u767d\u964d\u4f4e\uff0c\u767d\/\u7403\u86cb\u767d\u6bd4\u503c\u53d8\u5c0f\uff0c\u751a\u81f3\u5012\u7f6e\u3002\u4e25\u91cd\u8005\u51fa\u73b0\u660e\u663e\u4f4e\u767d\u86cb\u767d\u8840\u75c7\uff0c\u5f53\u8840\u6e05\u767d\u86cb\u767d\uff1c25g\/L\u65f6\uff0c\u53ef\u51fa\u73b0\u5168\u8eab\u6c34\u80bf\u53ca\u8179\u6c34\uff3b78\uff3d\u3002<\/p>\n
4.6 \u80be\u529f\u80fd \u598a\u5a20\u671f\u8840\u808c\u9150\u4f1a\u6709\u751f\u7406\u6027\u4e0b\u964d\uff0c\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\u663e\u8457\u589e\u52a0\u81f3\u598a\u5a20\u4e2d\u671f\u8fbe\u9ad8\u5cf0\uff08\u589e\u52a050%\u4ee5\u4e0a\uff09\u3002\u5b55\u4e2d\u671f\u8840\u6e05\u808c\u9150\u226560\u03bcmol\/L\u5e94\u8003\u8651\u80be\u529f\u80fd\u53d7\u635f\uff3b79\uff3d\u3002\u8840\u6e05\u534a\u80f1\u6c28\u9178\u86cb\u767d\u9176\u6291\u5236\u7269C\uff08cystatin C\uff09\u8f83\u8840\u808c\u9150\u66f4\u52a0\u654f\u611f\u3002<\/p>\n
4.7 \u5fc3\u8870\u6807\u5fd7\u7269 BNP\u53caN\u672b\u7aefB\u578b\u8111\u94a0\u80bd\u524d\u4f53\uff08NT-proBNP\uff09\u53ef\u7528\u4e8e\u598a\u5a20\u671f\u5fc3\u529b\u8870\u7aed\u8bca\u65ad\u4e0e\u9274\u522b\u8bca\u65ad\uff0c\u662f\u75c5\u60c5\u4e25\u91cd\u7a0b\u5ea6\u53ca\u9884\u540e\u8bc4\u4f30\u7684\u751f\u7269\u6807\u5fd7\u7269\uff3b29\uff0c80\uff3d\u3002\u5fc3\u8870\u8005\u65e0\u8bba\u6709\u65e0\u75c7\u72b6\uff0c\u8840\u6d46BNP\u6216NT-proBNP\u6c34\u5e73\u5747\u660e\u663e\u5347\u9ad8\uff0c\u5fc3\u8870\u6392\u9664\u53ca\u8bca\u65ad\u6807\u51c6\u89c1\u886811\u3002\u4ee5\u6cbb\u7597\u540e BNP\u3001NT-proBNP\u6bd4\u6cbb\u7597\u524d\u57fa\u7ebf\u6c34\u5e73\u7684\u4e0b\u964d\u5e45\u5ea6\u226530\uff05\u4f5c\u4e3a\u5224\u65ad\u6cbb\u7597\u6548\u679c\u7684\u6807\u51c6\uff0cBNP\u6216NT-proBNP \u68c0\u6d4b\u53ef\u4f5c\u4e3a\u6709\u6548\u7684\u5fc3\u8870\u7b5b\u67e5\u548c\u5224\u65ad\u9884\u540e\u7684\u6307\u6807\uff3b81-82\uff3d\u3002<\/p>\n<\/p>\n
5<\/p>\n
\u5f71\u50cf\u5b66\u68c0\u67e5 <\/p>\n
5.1 \u8d85\u58f0 2022\u5e74\u300a\u8d85\u58f0\u533b\u5b66\u8d28\u91cf\u63a7\u5236\u7ba1\u7406\u89c4\u8303\u300b\u89c4\u5b9a14\u9879\u8d85\u58f0\u5371\u6025\u503c\u9879\u76ee\uff0810min\u5185\u5b8c\u6210\u901a\u62a5\uff09\uff0c\u4e0e\u5b55\u4ea7\u5987\u76f8\u5173\u7684\u5305\u62ec\uff1a\u7591\u4f3c\u5f02\u4f4d\u598a\u5a20\u7834\u88c2\u5e76\u8179\u8154\u5185\u51fa\u8840\uff1b\u5b50\u5bab\u7834\u88c2\uff1b\u80ce\u76d8\u65e9\u5265\u3001\u524d\u7f6e\u80ce\u76d8\u5e76\u6d3b\u52a8\u6027\u51fa\u8840\uff1b\u665a\u671f\u598a\u5a20\u51fa\u73b0\u7f8a\u6c34\u8fc7\u5c11\u5e76\u80ce\u513f\u5fc3\u7387\u8fc7\u5feb\uff08\uff1e160\u6b21\/min\uff09\u6216\u8fc7\u6162\uff08\uff1c110\u6b21\/min\uff09\uff1b\u7591\u4f3c\u809d\u810f\u3001\u813e\u810f\u3001\u80be\u810f\u7834\u88c2\u51fa\u8840\uff1b\u6025\u6027\u80c6\u56ca\u708e\u8003\u8651\u80c6\u56ca\u5316\u8113\u5e76\u6025\u6027\u7a7f\u5b54\uff1b\u9996\u6b21\u53d1\u73b0\u5fc3\u529f\u80fd\u51cf\u9000\uff08\u5de6\u5fc3\u5ba4\u5c04\u8840\u5206\u6570\uff1c35%\uff09\uff1b\u5fc3\u5305\u79ef\u6db2\u5408\u5e76\u5fc3\u810f\u538b\u585e\uff1b\u4e3b\u52a8\u8109\u5939\u5c42\uff1b\u4e3b\u52a8\u8109\u7624\u7834\u88c2\uff1b\u5fc3\u810f\u7834\u88c2\uff1b\u5fc3\u810f\u6e38\u79bb\u8840\u6813\uff1b\u6025\u6027\u4e0a\u4e0b\u80a2\u52a8\u8109\u6813\u585e\uff1b\u74e3\u819c\u7f6e\u6362\u672f\u540e\u5361\u74e3\u3002\u53e6\u5916\u5982\u598a\u5a20\u5408\u5e76\u9ec4\u4f53\u7834\u88c2\u3001\u9644\u4ef6\u80bf\u5757\u626d\u8f6c\u7834\u88c2\u5e76\u8179\u8154\u5185\u5927\u91cf\u51fa\u8840\uff1b\u4e25\u91cd\u5b50\u5bab\u9888\u673a\u80fd\u4e0d\u5168\uff0c\u5b50\u5bab\u9888\u7ba1\u5168\u7a0b\u5f00\u653e\uff1b\u8110\u5e26\u8131\u5782\uff1b\u524d\u7f6e\u8840\u7ba1\uff1b\u80ce\u513f\u7a98\u8feb\u3001\u80ce\u513f\u5fc3\u8870\u3001\u6c34\u80bf\u7b49\u90fd\u4e25\u91cd\u5a01\u80c1\u6bcd\u513f\u751f\u547d\u5b89\u5168\uff3b83-84\uff3d\u3002<\/p>\n
5.2 CT\u3001\u78c1\u5171\u632f\u6210\u50cf\uff08MRI\uff09 \u5f71\u50cf\u5371\u6025\u503c\u5305\u62ec\uff1a\u9885\u5185\u8840\u80bf\u3001\u6025\u6027\u5927\u9762\u79ef\u8111\u6897\u6b7b\u3001\u4e00\u4fa7\u80ba\u4e0d\u5f20\u3001\u5f20\u529b\u6027\u6c14\u80f8\uff08\u5927\u4e8e50%\u4ee5\u4e0a\uff09\u3001\u6025\u6027\u80ba\u6c34\u80bf\u3001\u5fc3\u5305\u586b\u585e\u3001\u6025\u6027\u4e3b\u52a8\u8109\u5939\u5c42\u52a8\u8109\u7624\u3001\u6d88\u5316\u9053\u7a7f\u5b54\u3001\u6025\u6027\u80a0\u6897\u963b\uff0c\u5c24\u5176\u5728\u5b55\u4ea7\u5987\u4e2d\u9700\u8981\u5f15\u8d77\u9ad8\u5ea6\u91cd\u89c6\u3002<\/p>\n
5.2.1 MRI \u5b55\u671f\u4e00\u822c\u9009\u62e9MRI\u5e73\u626b\uff0c\u4e0d\u4f7f\u7528\u9486\u5bf9\u6bd4\u5242\u3002MRI\u5728\u8bc4\u4f30\u80ce\u76d8\u690d\u5165\u3001\u80ce\u76d8\u65e9\u5265\u548c\u5b50\u5bab\u7834\u88c2\u7b49\u65b9\u9762\u6709\u8f83\u9ad8\u51c6\u786e\u6027\uff3b85-86\uff3d\u3002MRI\u53ef\u4e3a\u598a\u5a20\u671f\u6025\u8179\u75c7\uff08\u4f8b\u5982\u6025\u6027\u9611\u5c3e\u708e\u3001\u80c6\u56ca\u708e\u3001\u80f0\u817a\u708e\u7b49\uff09\u7684\u51c6\u786e\u8bca\u65ad\u63d0\u4f9b\u6709\u529b\u652f\u6301\uff3b87-91\uff3d\u3002<\/p>\n
5.2.2 CT \uff081\uff09\u5b55\u4ea7\u5987\u6bcd\u4f53\u9aa8\u76c6\u9aa8\u6298\u3001\u8179\u90e8\u5668\u5b98\u635f\u4f24\u5916\u4f24\u8bc4\u4f30\u3002\uff082\uff09\u51fa\u8840\u6027\u75be\u75c5\u53ef\u4ee5\u8fc5\u901f\u8bc4\u4f30\u9885\u8111\u51fa\u8840\u7684\u60c5\u51b5\u3002\uff083\uff09CT\u8840\u7ba1\u9020\u5f71\uff08CTA\uff09\u8bca\u65ad\u80ba\u6813\u585e\u7684\u4ef7\u503c\u8f83\u9ad8\uff0c\u53ef\u4f5c\u4e3a\u6025\u6027\u4e3b\u52a8\u8109\u5939\u5c42\u8bca\u65ad\u7684\u91d1\u6807\u51c6\uff0c\u4f46\u68c0\u67e5\u6240\u9700\u9020\u5f71\u5242\u4e2d\u7684\u7898\u53ef\u4ee5\u901a\u8fc7\u80ce\u76d8\u8fdb\u5165\u80ce\u513f\u5faa\u73af\u548c\u7f8a\u6c34\u4e2d\uff0c\u5efa\u8bae\u5728\u8be6\u7ec6\u544a\u77e5\u6bcd\u513f\u6f5c\u5728\u98ce\u9669\u7684\u57fa\u7840\u4e0a\uff0c\u79ef\u6781\u884c\u76f8\u5173\u8bca\u65ad\u6027\u68c0\u67e5\u3002<\/p>\n
5.3 \u8840\u7ba1\u9020\u5f71 \u8840\u7ba1\u9020\u5f71\u53ef\u4ee5\u7528\u4e8e\u8bca\u65ad\u4ea7\u540e\u51fa\u8840\u7684\u539f\u56e0\uff0c\u5982\u5b50\u5bab\u52a8\u8109\u635f\u4f24\u3001\u52a8\u8109\u7624\u7b49\u3002<\/p>\n
6<\/p>\n
\u7ed3\u8bed<\/p>\n
\u5371\u91cd\u5b55\u4ea7\u5987\u65e9\u671f\u8bc6\u522b\u3001\u53ca\u65f6\u6709\u6548\u7ba1\u7406\u662f\u964d\u4f4e\u5b55\u4ea7\u5987\u6b7b\u4ea1\u7684\u5173\u952e\uff1b\u9700\u4ece\u60a3\u8005\u75c5\u53f2\u548c\u75c7\u72b6\u3001\u4f53\u5f81\u53ca\u8f85\u52a9\u68c0\u67e5\u5168\u9762\u7cfb\u7edf\u8bc4\u4f30\uff1b\u5c3d\u65e9\u53d1\u73b0\u3001\u6709\u6548\u8bc6\u522b\u53ef\u80fd\u9884\u793a\u5371\u6025\u91cd\u75c7\u53d1\u751f\u7684\u76f8\u5173\u6307\u6807\uff0c\u5bc6\u5207\u76d1\u6d4b\u3001\u53ca\u65f6\u5904\u7406\uff0c\u9002\u65f6\u542f\u52a8\u591a\u5b66\u79d1\u4f1a\u8bca\uff0c\u6700\u5927\u9650\u5ea6\u4fdd\u969c\u6bcd\u513f\u5b89\u5168\u3002 \u5229\u76ca\u51b2\u7a81\uff1a\u4e13\u5bb6\u7ec4\u6240\u6709\u6210\u5458\u5747\u58f0\u660e\u4e0d\u5b58\u5728\u5229\u76ca\u51b2\u7a81\u3002<\/p>\n
\u53c2\u8003\u6587\u732e<\/p>\n
\uff08\u5728\u6846\u5185\u6ed1\u52a8\u624b\u6307\u5373\u53ef\u6d4f\u89c8\uff09<\/p>\n
\uff3b1\uff3d\u4e2d\u534e\u533b\u5b66\u4f1a\u5987\u4ea7\u79d1\u5b66\u5206\u4f1a\u4ea7\u79d1\u5b66\u7ec4.\u80ce\u76d8\u65e9\u5265\u7684\u4e34\u5e8a\u8bca\u65ad\u4e0e\u5904\u7406\u89c4\u8303\uff08\u7b2c1\u7248\uff09\uff3bJ\uff3d.\u4e2d\u534e\u5987\u4ea7\u79d1\u6742\u5fd7\uff0c2012\uff0c49\uff0812\uff09\uff1a957-958.<\/p>\n
\uff3b2\uff3d Li Y\uff0cTian Y\uff0cLiu N\uff0cet al.Analysis of 62 placental abruption cases\uff1aRisk factors and clinical outcomes\uff3bJ\uff3d.Taiwan J Obstet Gynecol\uff0c2019\uff0c58\uff082\uff09\uff1a223-226.<\/p>\n
\uff3b3\uff3d\tXu D\uff0cLiang C\uff0cXu JW\uff0cet al.Analysis of misssed diagnosis and misdiagnosis of 1 212 cases with placental abruption\uff3bJ\uff3d. Zhonghua Fu Chan Ke Za Zhi\uff0c2017\uff0c52\uff085\uff09\uff1a294-300.<\/p>\n
\uff3b4\uff3d\t\u5e84\u749f\u6021\uff0c\u5e94\u8c6a.\u598a\u5a20\u671f\u5b50\u5bab\u7834\u88c2\u7684\u65e9\u671f\u8bc6\u522b\uff3bJ\uff3d.\u4e2d\u56fd\u5b9e\u7528\u5987\u79d1\u4e0e\u4ea7\u79d1\u6742\u5fd7\uff0c2023\uff0c39\uff084\uff09\uff1a406-411.<\/p>\n
\uff3b5\uff3d\tXu H\uff0cWang G\uff0cLi Q\uff0cet al.Clinical features\uff0cmanagement and maternal-infant prognosis in patients with complete uterine rupture in the second and third trimester of pregnancy\uff3bJ\uff3d. Altern Ther Health Med\uff0c2022\uff0c28\uff086\uff09\uff1a82-87.<\/p>\n
\uff3b6\uff3d\tSavukyne E\uff0cBykovaite-Stankeviciene R\uff0cMachtejeviene E\uff0cet al. Symptomatic uterine rupture\uff1aa fifteen year review\uff3bJ\uff3d.Medicina \uff08Kaunas\uff09\uff0c2020\uff0c56\uff0811\uff09\uff1a574.<\/p>\n
\uff3b7\uff3d Mossayebi MH\uff0cIyer NS\uff0cMclaren RA\uff0cet al.HELLP syndrome at \uff1c23 weeks’ gestation\uff1aa systematic literature review\uff3bJ\uff3d.Am J Obstet Gynecol\uff0c2023\uff0c229\uff085\uff09\uff1a502-515.e510.<\/p>\n
\uff3b8\uff3d Augustin G\uff0cHadzic M\uff0cJuras J\uff0cet al.Hypertensive disorders in pregnancy complicated by liver rupture or hematoma\uff1aa systematic review of 391 reported cases\uff3bJ\uff3d.World J Emerg Surg\uff0c2022\uff0c17\uff081\uff09\uff1a40.<\/p>\n
\uff3b9\uff3d Brito M\uff0cGamito M\uff0cNeves AR\uff0cet al.Conservative management of a pregnancy complicated by preeclampsia and postpartum spontaneous hepatic rupture\uff1aa case report and review of the literature\uff3bJ\uff3d.Eur J Obstet Gynecol Reprod Biol\uff0c2021\uff0c267\uff1a79-89.<\/p>\n
\uff3b10\uff3d Gao J\uff0cLiu Y\uff0cZhang Y\uff0cet al.Retrospective analysis of the clinical features and pregnancy outcomes in 124 pregnant patients with non-obstetric acute abdomen\uff3bJ\uff3d.Altern Ther Health Med\uff0c2023\uff0c29\uff088\uff09\uff1a644-649.<\/p>\n
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\uff3b12\uff3d\t \u674e\u535a\u96c5\uff0c\u6768\u6167\u971e.\u91cd\u89c6\u598a\u5a20\u671f\u6025\u6027\u8179\u75db\u7684\u9274\u522b\u8bca\u65ad\u6539\u5584\u56f4\u4ea7\u7ed3\u5c40\uff3bJ\uff3d.\u4e2d\u56fd\u5b9e\u7528\u5987\u79d1\u4e0e\u4ea7\u79d1\u6742\u5fd7\uff0c2023\uff0c39\uff084\uff09\uff1a385-386.<\/p>\n
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\uff3b57\uff3d\t \u9ec4\u7545\u6653\uff0c\u97e9\u5065\uff0c\u674e\u529b. \u7f8a\u6c34\u6813\u585e\u7684\u8bca\u65ad\u548c\u9274\u522b\uff3bJ\uff3d\uff0c\u5b9e\u7528\u5987\u4ea7\u79d1\u6742\u5fd7\uff0c2023\uff0c39\uff089\uff09\uff1a649-651.<\/p>\n
\uff3b58\uff3d\t \u9ec4\u7545\u6653\uff0c\u674e\u529b. \u4ea7\u540e\u51fa\u8840\u9884\u9632\u4e2d\u5b58\u5728\u7684\u95ee\u9898\u53ca\u7ba1\u7406\u7b56\u7565\uff3bJ\uff3d\uff0c\u4e2d\u56fd\u8ba1\u5212\u751f\u80b2\u548c\u5987\u4ea7\u79d1\uff0c2022\uff0c14\uff084\uff09\uff1a23-25.<\/p>\n
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\u672c\u6587\u520a\u767b\u4e8e\u300a\u4e2d\u56fd\u5b9e\u7528\u5987\u79d1\u4e0e\u4ea7\u79d1\u6742\u5fd7\u300b2024,40(5)\uff1a526-534 DOI … \u7ee7\u7eed\u9605\u8bfb