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題名 | First Successful Resuscitation of Mother and Delivery of Baby in a Patient with Severe H1N1 Complicated with ARDS in Taiwan: Experience with ECMO=臺灣首例成功急救母親及嬰兒在嚴重甲型H1N1流行病毒肺炎造成急性呼吸窘迫症候群之懷孕病人:體外膜氧合器使用經驗 |
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作者 | 邱光輝; 賴炳村; | 書刊名 | 胸腔醫學 |
卷期 | 28:3 2013.06[民102.06] |
頁次 | 頁147-153 |
分類號 | 417.3 |
關鍵詞 | 懷孕; 甲型H1N1流感病毒; 急性呼吸窘迫症侯群; 體外膜氧合器; Pregnancy; H1N1; Acute respiratory distress syndrome; Extracorporeal membrane oxygenation; |
語文 | 英文(English) |
中文摘要 | H1N1流感感染在高危險群病患,包括孕婦和女性產後期,可能非常嚴重,可能會致命。我們報告一個25歲懷孕34週G2P1婦女感染H1N1,咳嗽一個星期,發燒3天和呼吸窘迫5天。她到醫院時已呼吸衰竭,建議要插支氣管內管使用呼吸器時她轉院到我們醫院。住加護病房後插支氣管內管使用呼吸器治療,為了救小孩,緊急剖腹產成功,新生兒無嚴重併發症。她的肺炎進展到呼吸器無法有效治療之急性呼吸窘迫症侯群。我們使用體外膜氧合器和呼吸器的支持。雖然我們早期使用體外膜氧合器並給予肺保護性呼吸器補助,不幸的住院第3天後發生右側氣胸,需插胸管。但在一周內成功脫離體外膜氧合器。氣管內管在體外膜氧合器停止使用2天後拔管。拔管成功二天後轉到病房,2週後在病房拔出胸管。我們還回顧了相關文獻中關於嚴重H1N1病毒感染的孕婦,比各種輕重度,不同懷孕期,不同從感染到治療的時間對疾病的治療效果。 |
英文摘要 | H1N1 infection can be very severe and even fatal in high-risk patients including pregnant mothers and females during the peri-partum period. We report the 1st case of mother and fetus that were saved during the 2009 H1N1 pandemic in Taiwan. A 25-yearold G2P1 woman at 34 weeks gestation was infected with H1N1 and progressed to ARDS refractory to ventilatory support with 100% O2. Emergent caesarian delivery was performed and the baby had an uneventful recovery. The mother was treated aggressively with ECMO and unfortunately developed right-side pneumothorax despite early ECMO use and lung protective ventilation because of tension bullae, which were either acquired or congenital. She was successfully weaned from ECMO within 1 week with subsequent extubation of the endotracheal tube. Her chest tube was removed after 2 weeks in the chest medicine ward. We also reviewed the related literature on severe H1N1 infection among pregnant women, the relationship of various outcomes at different gestational ages, differences in duration from infection to treatment, and also the effect of ECMO use. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。