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1、高危孕产妇的管理和临床救治Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.高危孕产妇的早识别早诊断 首先依赖于各位、依赖于我们县、乡、 村的三级网络。 网底清数管理，村妇女主任、责任医生
2、培训，充分发挥由下而上网底作用。 早建卡（孕13周前）、孕4月、孕6月复 诊进行产前筛查及三围B超检查、孕28 周以后要求所有孕妇都应该到县级医院 妇产科再次高危筛查。Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 A
3、spose Pty Ltd.Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.开始于受孕及孕前Evaluation only.Evaluation only. Created with As
4、pose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.常见高危因素 孕妇基本情况：年龄、身高、体质、不 孕史 不良孕产史 内外科合并症 产科并发症 社会因素：经济、文化、交通等Evaluation only.Evaluation only. Created with Aspose.Slid
5、es for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.高危管理原则（1） 不论早、中、晚孕，每一次的检查 都应该是系统全面的，以尽早地筛 查、识别、诊断高危妊娠，规范高 危管理。 想方设法不断提高高危妊娠管理的“ 三率”：检出率、随诊率、住院分娩 率。Evaluation only.Evaluation o
6、nly. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.孕4月产前筛查Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2
7、.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.中孕及晚孕各期检查Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5
8、.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.高危管理原则（2） 筛查出妊娠禁忌症的，给会诊后，动员 尽早终止妊娠。可以继续妊娠的，要选 择最佳时机、最有利的分娩方式，有计 划地分娩。 同时要强调的是我们必须注重宣教：通 过注意饮食、环境、避免感染及药物影 响等多环节来积极预防。Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created w
9、ith Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-
10、2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.孕产妇的危急重症（1） 气道：
11、阻塞 呼吸：25-30次或 6次，端坐呼吸， SPO2 90%,紫绀、 哮鸣音 循环：血压、心率 130次，胸痛背痛 泌尿：少尿无尿血尿 血液：出血、不凝、 淤斑、三系减少 高热 神经：意识下降、紊 乱、抽搐 消化：腹痛腹胀黄疸Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose
12、 Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.危急重症（2） 需关注的病人：疼痛不止、治疗无效、 不能及时得到急救、有纠纷可能的，有 不良孕产史 胎儿因素：巨大儿、胎位异常、双胎妊 娠Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose
13、Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.院内急救管理 急诊往往以发热、腹痛、阴道出血、呼 吸困难等症状就诊，必要时应该在内、 外科医生配合下进行快速鉴别，初步诊 断，将产科的急诊识别出来，积极处理 ，防止发展到危重程度。 对急诊做出最快速的反应Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.
14、0.0. Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.院内急救管理（一） （一）急诊的初步处理 任何急诊的最初步骤包括： 1.让患者平静，医务人员的思考要有逻 辑，关注患者的需要 2.要时刻有人关照患者。 3.专人负责，以免造成混乱 4.呼救Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET
15、 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.院内急救管理（一） 5.如患者昏迷则评估其呼吸道是否通畅 ，呼吸、循环状况。 6.如已表现为休克，则即刻进行抢救（ 保持呼吸道通畅、建立静脉通道等）； 如怀疑休克，应立即治疗；对有可能发 展为休克的，应立即做好预防。 7.患者左侧卧位，下肢抬高，解开衣服Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 C
16、lient Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.Copyright 2004-2011 Aspose Pty Ltd.院内急救管理（一） 8.与患者交谈，帮其平静，询问病史 9.在询问、安顿同时，尽快检查：生命 体征、皮肤颜色、估计失血量、评估症 状及体征。 10.若需转诊的，紧急转诊到上级医院， （转诊前完成所有紧急治疗）Evaluation only.Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0.Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2
