对羊水栓塞的再认识

羊水栓塞是严重而罕见的产科并发症，其发病机制至今尚未阐明。一直以来，诊断羊水栓塞的金标准是在母体中心静脉血或肺动脉血管床组织切片中找到胎儿的有形成分，但目前的研究已使羊水栓塞的诊断受到质疑，母血中找到胎儿有形成分不再是诊断的必须依据。对于羊水栓塞的诊断，国内强调的是发病机制和病理过程，国外强调的是临床表现。目前认为羊水栓塞的发生无法通过对高危因素的识别和干预进行预测和预防。发生羊水栓塞后的抢救重点主要是支持和对症治疗。

Recognization of amniotic fluid embolism

Amniotic fluid embolism (AFE) is a rare but severe complication of pregnancy, and the pathogenesis of amniotic fluid embolism is still poorly understood. The diagnostic criteria of AFE is that fetal tissue was found in the mother′s central vein or pulmonary artery. However, as advances in research, the diagnosis of AFE has been changed. In China, the pathogenesis and pathological process of AFE is emphasized. In the other counties, the clinical manifestation of AFE is emphasized. At present, it is believed that no predicted or preventive measures are possible for AFE through identifying the risk factors. The key point of treating AFE is primarily the supportive and symptomatic treatment.