国际妇产科学杂志 ›› 2023, Vol. 50 ›› Issue (5): 491-496.doi: 10.12280/gjfckx.20230253

• 产科生理及产科疾病:综述 • 上一篇    下一篇

休克指数在产后出血中应用的研究进展

秦诗溢, 邵勇()   

  1. 400016 重庆医科大学附属第一医院妇产科
  • 收稿日期:2023-04-02 出版日期:2023-10-15 发布日期:2023-10-16
  • 通讯作者: 邵勇,E-mail:cqshaoyong@163.com
    审校者
  • 基金资助:
    国家重点研发计划(2021YFC2701500);国家重点研发计划(2021YFC2701501);国家重点研发计划(2021YFC2701505)

Research Progress on the Application of Shock Index in Postpartum Hemorrhage

QIN Shi-yi, SHAO Yong()   

  1. Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
  • Received:2023-04-02 Published:2023-10-15 Online:2023-10-16
  • Contact: SHAO Yong, E-mail: cqshaoyong@163.com

摘要:

产后出血(postpartum hemorrhage)是产科常见的严重并发症,也是全球孕产妇死亡的首要原因,降低其不良结局发生率的关键在于早期快速识别和及时干预,但临床诊断标准大多是基于对出血量的视觉估计,出血的严重程度很可能会被低估,易导致临床对产后出血的延迟诊断及治疗。近年来,多项研究提出休克指数(shock index,SI)可以提示血流动力学的不稳定性,用于预测产后出血的发生、发展及不良结局,尤其在医疗资源匮乏的地区,其应用价值更大。而与其相关的休克指数差值(delta-shock index,ΔSI)可以进一步个体化评估出血情况。虽然SI作为产后出血的预测指标有一定的局限性,但总体而言,其临床价值是值得肯定的。

关键词: 产后出血, 休克, 出血性, 血流动力学, 预测, 休克指数, 休克指数差值

Abstract:

Postpartum hemorrhage is a common serious complication in obstetrics and the leading cause of maternal death worldwide. The key to reduce the incidence of its adverse outcomes lies in early and rapid identification and timely intervention. However, the clinical diagnostic criteria are mostly based on visual estimation of blood loss, and the severity of hemorrhage is likely to be underestimated, which can easily leads to delayed clinical diagnosis and treatment of postpartum hemorrhage. In recent years, a number of studies have proposed that shock index (SI) can alert hemodynamic instability and be used to predict the occurrence, development and adverse outcome of postpartum hemorrhage. Especially in areas with scarce medical resources, the application value of SI is greater. The relative delta-shock index (ΔSI) can further individualize the assessment of bleeding. SI as a predictor of postpartum hemorrhage has some limitations, but overall, its clinical value is worthy of recognizing.

Key words: Postpartum hemorrhage, Shock, hemorrhagic, Hemodynamics, Forecasting, Shock index, Delta-shock index