593 E 1 PGE 1 EPA γ- ALI ARDS 1. / GC NO 2006 J. 2007 16 4 343-349. PS ARDS 1 2Pereira A Krieger BP. Pulmonary complications of pregnancy J. Clin Chest Med 2004 25299-310. GC PS 3Venkata DB Uma M Michael AM. Acute lung injury and acute ALI ARDS 14-15 respiratory distress syndrome in pregnancyj. Crit Care Clin ALI ARDS 2004 20577-607. 4. M. 7. 200836-37. 3. 5 5. 178 J. 2011 39 338. ALI ARDS 6. ARDS J. 2007 4210 655-657. 7. J. 1 2008 241 34-36. ARDS 8. J. 2005 3. 6 ARDS 346 4-5. 9. 1996-2010 J. 2011 4510934-939. ARDS ICU 10te Raa GD Ribbert LS Snijder RJ. Treatment options in massive pulmonary embolism during pregnancya case-report and review of literature J. Thrombosis Research 20091241-5. 3. 7 ALI ARDS J. Clin Chest Med 2011 321 121-132. 12. M. 2-3 19982-3. 1 13. M. 7. > 160 /min > 180 /min 2008150-155. 2 < 120 /min 14. < 100 /min 3 J. 2011 28 2 67-69. 15van Kaam AH Haitsma JJ Dik WA et al. Response to exogenous surfact- ant is different during open lung and conventional ventilation J. Crit Care Med 2004 323 774-780. 4 ALI ALI ARDS ALI ARDS 11Brito VNiederman MS. Pneumonia complicating pregnancy 1005-2216201208 - 0593-05 2012-04 - 15 ALI ARDS 510515 lphuang2006@ 126. com ALI ARDS
594 kpa R714. 46 + 1 C AbstractPoor prognosis of postpartum hemorrhagic shock is connected with failure of timely and effective treatment. We provide a brief review of application of limited fluid resuscitation in postpartum hemorrhagic shock and the effect of limited fluid resuscitation on blood losscomplications of shockorgan function protection and the prognosis of postpartum hemorrhagic shock. Keywordshemorrhagic shockpostpartum hemorrhagelimited fluid resuscitationmultiple organ dysfunction 1994 2006 40 mmhg MODS 65 mmhg 2008 2011 Bjrn 5 35 664 1351 0 ~ 1500 ml 2000 ml Hb MODS 90 MAP 50 mmhg MAP 65 mm- Hg 1 MAP40 ~ 50 mmhg 1 mmhg = 0. 133 6 2 MODS ARF 2-3 1992
595 3 10-15 ARDS ARF MAP 50 ~ 60 DIC MODS 1 2 3 MODS 1 HCT Hb MODS 7 2 MODS 3 ET VIP - SIRS SIRS MODS MODS mmhg SIRS 4 SIRS 8 206 MODS MODS SIRS 30. 6% 5 29. 1% 6 -α TNF-α MODS 2 41% 3 3 50% ~ 100% 9 8 MODS 17. 5% 5. 9 MODS 80 MAP 50 ~ 60 mmhg MAP 50 ~ 60 mmhg MAP > 60 mmhg 700 ml 1050 ml vs. 1750 ml Hb
596 APTT PT MODS Sapinens Publishing 20062-11. 4 2Friedman Z Berkenstadt H Preisman S et al. A comparison of lactated ringer s solution to hydroxyethyl starch 6% in a model of severe hemorrhagic shock and continuous bleeding in dogs 1 J. Anesth Analg 2003 961 39-45. 2 3Morrissey JH. Tissue factora key molecule in hemostatic and 3 nonhemostatic systemsj. Int J Hematol 2004 79 2 103-108. 4 4. J. 2004 243 178-181. 5Bjrn Huβmann Rolf Lefering Georg Taeger et al. Influence of prehospital fluid resuscitation on patients with multiple injuries in hemorrhagic shock in patients from the DGU trauma registry J. Emerg Trauma Shock 2011 44 465-471. 6Morrison CA Carrick MM Norman MA. Hypotensive resuscitation strategy reduces transfusion requirements and severe postoperative coagulopathy in trauma patients withhemorrhagic shock preliminary results of a randomized controlled trialj. J Trauma 2011 703 652-663. 50% ~ 85% 7Afssa B Green B Delke I et al. Systemic inflanunatory response syndrome organ failure and outcome in critically ill obs- letric patients treated in an ICU J. Chest 2001 1204 1271- HCT 1277. 8. J. 2007 1042 SV DO 2 655-657. 9. M. SvO 2 200585-91. 10. J. 16-17 2004 103 162-165. 2004 SvO 2 > 0. 7 18 11. J. 2008 43 1 50-53. 12. J. 2008 28 6 5 1Christoper BL. A textbook of postpartum hemorrhagem. UK 1042-1045. 13. J.
597 2011 39 1530-1533. 14Yu YH Gong SP Sheng C et al. Increased survival with hypotensive resuscitation in a rabbit model of uncontrolled hemorrhagic shock in pregnancyj. Resuscitation 2009 80 12 1424-1430. 15Sheng C Yu YH Zhao KS et al. Acute lung inflammatory response and injury after hemorrhagic shock are more severe in postpartum rabbitsj. Crit Care Med 2012 40 5 1570-1577. 16Lobo SM Salgado PF Castillo VG et al. Effects of maximizing oxygen delivery on morbidity and mortality in high-risk surgical patients J. Crit Care Med 2000 28103396-3404. 17Bundgaard-nielsen M Secher NH Kehlet H. Liberal vs. restrictive perioperative fluid therapy-a critical assessment of the evidencej. Acta An aesthesiologica Scandinavica 2009 53 7 843-851. 18Dellinger RP Carlet JM Masur H et al. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock J. Crit Care Med 2004 323 858-873. 1005-2216201208 - 0597-04 2012-05 - 05 2012-05 - 16 2 2. 1 R715. 3 C AbstractAntenatal administration of glucocorticoid large dose of ambroxol hydrochloride and alveolar surfactant preparation can promote the production of alveolar surfactantwhich can reduce the onset of NRDS on premature after birth and increase the survival rate of newborns. Keywordsacceleration of fetal lung maturationglucocorticoidambroxol hydrochloridepulmonary surfactant NRDS NRDS pulmonary surfactant PS NRDS β- 1 PS 25 22 ~ 24 PS 26 ~ 32 Ⅰ Ⅱ PS 34 ~ 35 PS 34 PS 1969 Liggins 1972 Liggins NRDS - Ⅱ PS RDS PS 110004 duj@ sj - hospital. org FASN PS