子癇:修订间差异
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'''子癇'''({{lang-en|Eclampsia}})是指孕婦因為[[妊娠毒血症]]而產生的{{le|癲癇發作|Epileptic seizure|癲癇}}症狀<ref name=W2014/>。妊娠毒血症是在妊娠期間的疾病,其症狀為[[高血壓]]、[[蛋白尿]]或其他器官功能的異常<ref>{{cite journal|last1=Lambert|first1=G|last2=Brichant|first2=JF|last3=Hartstein|first3=G|last4=Bonhomme|first4=V|last5=Dewandre|first5=PY|title=Preeclampsia: an update.|journal=Acta anaesthesiologica Belgica|date=2014|volume=65|issue=4|pages=137–49|pmid=25622379}}</ref><ref name=ACOG2013>{{cite journal|title=Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy.|journal=Obstet Gynecol.|date=Nov 2013|volume=122|issue=5|pages=1122–31|doi=10.1097/01.AOG.0000437382.03963.88|pmid=24150027|url=http://www.tsop.org.tw/db/CFile/File/8-1.pdf}}</ref>。子癇可能會在分娩前、分娩中或分娩後發生<!-- <ref name=W2014/> -->。子癇的癲癇是屬於[[強直-陣攣性發作]],約會持續一分鐘<!-- <ref name=W2014/> -->。在癲癇後可能會處於{{le|癲癇發作后狀態|Postictal state}}或是[[昏迷]]<!-- <ref name=W2014/> -->。併發症有{{le|吸入性肺炎|Aspiration pneumonia}}、{{le|腦出血|Cerebral hemorrhage}}、[[腎功能衰竭]]或是[[心搏停止]]<!-- <ref name=W2014/> -->。妊娠毒血症及子癇都可歸類為{{le|妊娠高血壓|Hypertensive disease of pregnancy}}<ref name=W2014>{{cite book|title=Williams obstetrics|date=2014|publisher=McGraw-Hill Professional|isbn=9780071798938|edition=24th|chapter=40}}</ref>。 |
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'''子癇'''(eclampsia)是妊娠晚期、临产时、新产后发生的急性脑病,常出现[[抽搐]]和[[昏迷]]([[癲癇發作]]),机制类似[[高血压脑病]]。子痫多数在[[先兆子痫]]基础上发作<ref name=W2014/>。子癇前症是一種{{le|妊娠高血壓疾病|Hypertensive disease of pregnancy}},且常併發[[水腫]]、[[蛋白尿]]或其他器官功能異常<ref>{{Cite journal|title=Preeclampsia: an update|url=https://pubmed.ncbi.nlm.nih.gov/25622379|last=Lambert|first=G.|last2=Brichant|first2=J. F.|date=2014|journal=Acta Anaesthesiologica Belgica|issue=4|volume=65|pages=137–149|issn=0001-5164|pmid=25622379|last3=Hartstein|first3=G.|last4=Bonhomme|first4=V.|last5=Dewandre|first5=P. Y.|access-date=2020-12-24|archive-date=2021-02-28|archive-url=https://web.archive.org/web/20210228025441/https://pubmed.ncbi.nlm.nih.gov/25622379/|dead-url=no}}</ref><ref name="ACOG2013">{{Cite journal|title=Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy|url=https://pubmed.ncbi.nlm.nih.gov/24150027|last=American College of Obstetricians and Gynecologists|last2=Task Force on Hypertension in Pregnancy|date=2013-11|journal=Obstetrics and Gynecology|issue=5|doi=10.1097/01.AOG.0000437382.03963.88|volume=122|pages=1122–1131|issn=1873-233X|pmid=24150027|access-date=2020-12-24|archive-date=2020-11-21|archive-url=https://web.archive.org/web/20201121181237/https://pubmed.ncbi.nlm.nih.gov/24150027/|dead-url=no}}</ref>。子癇可能會在分娩前、分娩中或分娩後發生。 |
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子癇的发作是一种[[全身强直阵挛发作]],約會持續一分鐘。在癲癇後可能會處於{{le|癲癇發作后狀態|Postictal state}}或是[[昏迷]]。併發症有[[吸入性肺炎]]、[[腦出血]]、[[腎功能衰竭]]或是[[心搏停止]]。[[子癇前症]]及子癇都可歸類為[[妊娠高血压疾病]]<ref name="W2014">{{cite book|title=Williams obstetrics|url=https://archive.org/details/williamsobstetri0024unse|date=2014|publisher=McGraw-Hill Professional|isbn=9780071798938|edition=24th|chapter=40}}</ref>或妊娠高血压综合征(妊高征)。 |
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==字源及歷史== |
==字源及歷史== |
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{{lang-en|eclampsia}}源自{{lang-el|ἐκλαμψία}}({{IAST|eklampsía}},意為[[閃電]],[[隱喻]]其短暫爆發的特性) |
{{lang-en|eclampsia}}源自{{lang-el|ἐκλαμψία}}({{IAST|eklampsía}},意為[[閃電]],[[隱喻]]其短暫爆發的特性)。第一個有關子癇症狀的描述是在西元前五世紀的[[希波克拉底]]<ref name="Em2006">{{Cite book|title=Advanced Therapy in Hypertension and Vascular Disease|url=https://books.google.ca/books?id=sCgURxhCJ-8C&pg=PA407|publisher=PMPH-USA|date=2006|isbn=978-1-55009-318-6|language=en|first=Emile R.|last=Mohler|first2=Raymond R.|last2=Townsend|pages=407–408|access-date=2016-03-09|archive-date=2015-10-05|archive-url=https://web.archive.org/web/20151005013555/https://books.google.ca/books?id=sCgURxhCJ-8C&pg=PA407|dead-url=no}}</ref>。 |
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==預防及治療方式== |
==預防及治療方式== |
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建議的預防方式如下:高風險者服用[[阿斯匹靈]],若鈣質攝取量不足,使用[[鈣質補充劑]],針對早期的高血壓給予藥物治療<ref name=WHO2011>{{cite book|title=WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia.|year=2011|isbn=978-92-4-154833-5|url=http://whqlibdoc.who.int/publications/2011/9789241548335_eng.pdf}}</ref><ref name=Hend2014>{{ |
建議的預防方式如下:高風險者服用[[乙酰水杨酸|阿斯匹靈]],若鈣質攝取量不足,使用[[鈣質補充劑]],針對早期的高血壓給予藥物治療<ref name="WHO2011">{{cite book|title=WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia.|year=2011|isbn=978-92-4-154833-5|url=http://whqlibdoc.who.int/publications/2011/9789241548335_eng.pdf|accessdate=2016-03-09|archivedate=2015-05-13|archiveurl=https://web.archive.org/web/20150513050104/http://whqlibdoc.who.int/publications/2011/9789241548335_eng.pdf|dead-url=no}}</ref><ref name="Hend2014">{{Cite journal|title=Low-dose aspirin for prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force|url=https://pubmed.ncbi.nlm.nih.gov/24711050|last=Henderson|first=Jillian T.|last2=Whitlock|first2=Evelyn P.|date=2014-05-20|journal=Annals of Internal Medicine|issue=10|doi=10.7326/M13-2844|volume=160|pages=695–703|issn=1539-3704|pmid=24711050|last3=O'Connor|first3=Elizabeth|last4=Senger|first4=Caitlyn A.|last5=Thompson|first5=Jamie H.|last6=Rowland|first6=Maya G.|access-date=2020-12-24|archive-date=2020-09-03|archive-url=https://web.archive.org/web/20200903015349/https://pubmed.ncbi.nlm.nih.gov/24711050/|dead-url=no}}</ref>。在懷孕期間運動也會有幫助<ref name="W2014" />。若有子癇症狀,肌肉注射或靜脈注射[[硫酸鎂]]可改善症狀,一般來說是安全的<ref name="BMC2013">{{Cite journal|title=An integrative review of the side effects related to the use of magnesium sulfate for pre-eclampsia and eclampsia management|url=https://pubmed.ncbi.nlm.nih.gov/23383864|last=Smith|first=Jeffrey Michael|last2=Lowe|first2=Richard F.|date=2013-02-05|journal=BMC pregnancy and childbirth|doi=10.1186/1471-2393-13-34|volume=13|pages=34|issn=1471-2393|pmc=3570392|pmid=23383864|last3=Fullerton|first3=Judith|last4=Currie|first4=Sheena M.|last5=Harris|first5=Laura|last6=Felker-Kantor|first6=Erica|access-date=2020-12-24|archive-date=2022-01-09|archive-url=https://web.archive.org/web/20220109031017/https://pubmed.ncbi.nlm.nih.gov/23383864/}}</ref><ref>{{Cite journal|title=A systematic review of maternal and infant outcomes following magnesium sulfate for pre-eclampsia/eclampsia in real-world use|url=https://pubmed.ncbi.nlm.nih.gov/22703834|last=McDonald|first=Sarah D.|last2=Lutsiv|first2=Olha|date=2012-08|journal=International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics|issue=2|doi=10.1016/j.ijgo.2012.01.028|volume=118|pages=90–96|issn=1879-3479|pmid=22703834|last3=Dzaja|first3=Nancy|last4=Duley|first4=Lelia|access-date=2020-12-24|archive-date=2021-12-21|archive-url=https://web.archive.org/web/20211221112709/https://pubmed.ncbi.nlm.nih.gov/22703834/}}</ref>,在[[已開發國家]]及[[開發中國家]]都適用<ref name="BMC2013" />。可能也需要設備來輔助呼吸,其他的治療包括高血壓藥物[[肼屈嗪]]以及用陰道分娩或是[[剖宮產]]方式緊急將胎兒生下<ref name="W2014" />。 |
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==流行病學,預後== |
==流行病學,預後== |
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產婦中約有5%會得到 |
產婦中約有5%會得到子癇前症,其中约28%(总数1.4%)会发子癇<ref>{{Cite journal|title=Global and regional estimates of preeclampsia and eclampsia: a systematic review|url=https://pubmed.ncbi.nlm.nih.gov/23746796|last=Abalos|first=Edgardo|last2=Cuesta|first2=Cristina|date=2013-09|journal=European Journal of Obstetrics, Gynecology, and Reproductive Biology|issue=1|doi=10.1016/j.ejogrb.2013.05.005|volume=170|pages=1–7|issn=1872-7654|pmid=23746796|last3=Grosso|first3=Ana L.|last4=Chou|first4=Doris|last5=Say|first5=Lale|access-date=2020-12-24|archive-date=2021-03-08|archive-url=https://web.archive.org/web/20210308134503/https://pubmed.ncbi.nlm.nih.gov/23746796/|dead-url=no}}</ref>。已開發國家因為醫療的改善,每2000名產婦約有1名會得到子癇<ref name="W2014" />。妊娠高血壓是懷孕期最常見的死因之一<ref name="Aru2013">{{Cite journal|title=Severe pre-eclampsia and hypertensive crises|url=https://pubmed.ncbi.nlm.nih.gov/23962474/|last=Arulkumaran|first=N.|last2=Lightstone|first2=L.|date=2013-12|journal=Best Practice & Research. Clinical Obstetrics & Gynaecology|issue=6|doi=10.1016/j.bpobgyn.2013.07.003|volume=27|pages=877–884|issn=1532-1932|pmid=23962474|access-date=2020-12-24|archive-date=2020-09-02|archive-url=https://web.archive.org/web/20200902080637/https://pubmed.ncbi.nlm.nih.gov/23962474/|dead-url=no}}</ref>。2013年因妊娠高血壓死亡的人數為二萬九千人,較1990年的三萬七千人要少<ref>{{Cite journal|title=Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013|url=https://pubmed.ncbi.nlm.nih.gov/25530442|last=GBD 2013 Mortality and Causes of Death Collaborators|date=2015-01-10|journal=[[柳葉刀 (雜誌)|Lancet]] (London, England)|issue=9963|doi=10.1016/S0140-6736(14)61682-2|volume=385|pages=117–171|issn=1474-547X|pmc=4340604|pmid=25530442|access-date=2020-12-24|archive-date=2021-03-08|archive-url=https://web.archive.org/web/20210308112250/https://pubmed.ncbi.nlm.nih.gov/25530442/|dead-url=no}}</ref>。患有子癇的女性中,約有1%因此死亡<ref name="W2014" />。 |
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==參考資料== |
==參考資料== |
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{{reflist}} |
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[[Category:懷孕]] |
[[Category:懷孕]] |
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[[Category:產科學]] |
[[Category:產科學]] |
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[[Category:婦科疾病]] |
[[Category:婦科疾病]] |
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[[pl:Nadciśnienie tętnicze w ciąży#Rzucawka]] |
2024年7月19日 (五) 03:55的最新版本
子癇 | |
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类型 | 妊娠毒血症、疾病、life emergency[*] |
分类和外部资源 | |
醫學專科 | 產科學 |
ICD-11 | JA25 |
ICD-10 | O15 |
ICD-9-CM | 642.6 |
DiseasesDB | 4068 |
MedlinePlus | 000899 |
eMedicine | 253960、1476919 med/1905 emerg/796 |
MeSH | D004461 |
子癇(eclampsia)是妊娠晚期、临产时、新产后发生的急性脑病,常出现抽搐和昏迷(癲癇發作),机制类似高血压脑病。子痫多数在先兆子痫基础上发作[1]。子癇前症是一種妊娠高血壓疾病,且常併發水腫、蛋白尿或其他器官功能異常[2][3]。子癇可能會在分娩前、分娩中或分娩後發生。
子癇的发作是一种全身强直阵挛发作,約會持續一分鐘。在癲癇後可能會處於癲癇發作后狀態或是昏迷。併發症有吸入性肺炎、腦出血、腎功能衰竭或是心搏停止。子癇前症及子癇都可歸類為妊娠高血压疾病[1]或妊娠高血压综合征(妊高征)。
字源及歷史
[编辑]英語:eclampsia源自希臘語:ἐκλαμψία(eklampsía,意為閃電,隱喻其短暫爆發的特性)。第一個有關子癇症狀的描述是在西元前五世紀的希波克拉底[4]。
預防及治療方式
[编辑]建議的預防方式如下:高風險者服用阿斯匹靈,若鈣質攝取量不足,使用鈣質補充劑,針對早期的高血壓給予藥物治療[5][6]。在懷孕期間運動也會有幫助[1]。若有子癇症狀,肌肉注射或靜脈注射硫酸鎂可改善症狀,一般來說是安全的[7][8],在已開發國家及開發中國家都適用[7]。可能也需要設備來輔助呼吸,其他的治療包括高血壓藥物肼屈嗪以及用陰道分娩或是剖宮產方式緊急將胎兒生下[1]。
流行病學,預後
[编辑]產婦中約有5%會得到子癇前症,其中约28%(总数1.4%)会发子癇[9]。已開發國家因為醫療的改善,每2000名產婦約有1名會得到子癇[1]。妊娠高血壓是懷孕期最常見的死因之一[10]。2013年因妊娠高血壓死亡的人數為二萬九千人,較1990年的三萬七千人要少[11]。患有子癇的女性中,約有1%因此死亡[1]。
參考資料
[编辑]- ^ 1.0 1.1 1.2 1.3 1.4 1.5 40. Williams obstetrics 24th. McGraw-Hill Professional. 2014. ISBN 9780071798938.
- ^ Lambert, G.; Brichant, J. F.; Hartstein, G.; Bonhomme, V.; Dewandre, P. Y. Preeclampsia: an update. Acta Anaesthesiologica Belgica. 2014, 65 (4): 137–149 [2020-12-24]. ISSN 0001-5164. PMID 25622379. (原始内容存档于2021-02-28).
- ^ American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstetrics and Gynecology. 2013-11, 122 (5): 1122–1131 [2020-12-24]. ISSN 1873-233X. PMID 24150027. doi:10.1097/01.AOG.0000437382.03963.88. (原始内容存档于2020-11-21).
- ^ Mohler, Emile R.; Townsend, Raymond R. Advanced Therapy in Hypertension and Vascular Disease. PMPH-USA. 2006: 407–408 [2016-03-09]. ISBN 978-1-55009-318-6. (原始内容存档于2015-10-05) (英语).
- ^ WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia. (PDF). 2011 [2016-03-09]. ISBN 978-92-4-154833-5. (原始内容存档 (PDF)于2015-05-13).
- ^ Henderson, Jillian T.; Whitlock, Evelyn P.; O'Connor, Elizabeth; Senger, Caitlyn A.; Thompson, Jamie H.; Rowland, Maya G. Low-dose aspirin for prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force. Annals of Internal Medicine. 2014-05-20, 160 (10): 695–703 [2020-12-24]. ISSN 1539-3704. PMID 24711050. doi:10.7326/M13-2844. (原始内容存档于2020-09-03).
- ^ 7.0 7.1 Smith, Jeffrey Michael; Lowe, Richard F.; Fullerton, Judith; Currie, Sheena M.; Harris, Laura; Felker-Kantor, Erica. An integrative review of the side effects related to the use of magnesium sulfate for pre-eclampsia and eclampsia management. BMC pregnancy and childbirth. 2013-02-05, 13: 34 [2020-12-24]. ISSN 1471-2393. PMC 3570392 . PMID 23383864. doi:10.1186/1471-2393-13-34. (原始内容存档于2022-01-09).
- ^ McDonald, Sarah D.; Lutsiv, Olha; Dzaja, Nancy; Duley, Lelia. A systematic review of maternal and infant outcomes following magnesium sulfate for pre-eclampsia/eclampsia in real-world use. International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics. 2012-08, 118 (2): 90–96 [2020-12-24]. ISSN 1879-3479. PMID 22703834. doi:10.1016/j.ijgo.2012.01.028. (原始内容存档于2021-12-21).
- ^ Abalos, Edgardo; Cuesta, Cristina; Grosso, Ana L.; Chou, Doris; Say, Lale. Global and regional estimates of preeclampsia and eclampsia: a systematic review. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2013-09, 170 (1): 1–7 [2020-12-24]. ISSN 1872-7654. PMID 23746796. doi:10.1016/j.ejogrb.2013.05.005. (原始内容存档于2021-03-08).
- ^ Arulkumaran, N.; Lightstone, L. Severe pre-eclampsia and hypertensive crises. Best Practice & Research. Clinical Obstetrics & Gynaecology. 2013-12, 27 (6): 877–884 [2020-12-24]. ISSN 1532-1932. PMID 23962474. doi:10.1016/j.bpobgyn.2013.07.003. (原始内容存档于2020-09-02).
- ^ GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet (London, England). 2015-01-10, 385 (9963): 117–171 [2020-12-24]. ISSN 1474-547X. PMC 4340604 . PMID 25530442. doi:10.1016/S0140-6736(14)61682-2. (原始内容存档于2021-03-08).