妇产科学

eclampsia　　Whenapregnantpatientconvulsesonemustimmediatelythinkofeclampsiaparticualrlyduringthelasttrimester.However,theimmediatetreatmentisthesamenomatterwhatthegenesisoftheconvulsion.ManagementoftheConvulsion　A.Insertsomethingbetweentheteethtopreventlacerationofthetongueand/orlips;paddedtongueblade,mouthgag,wallet,etc.Clearmouthofmaterialthatmayhavebeenregurgitatedfromthestomach.Ventilatebymouthtomouthorwithbagandmaskifrespiratoryexchangeisinadequate.Laryngoscopywithendotrachealintubationmaybenecessary.　B.Insertanairwaytofacilitateairexchangeandtopreventswallowingofthetongue.　C.Placesomethingundertheheadtoavoidtrauma-sweater,towel,etc.　D.Ifitisavailable,administeroxygen.Inattemptstoascertainthecauseoftheseizure,ahistoryshouldbeobtainedfromtherelativesorfriends;bodyandpurseshouldbesearchedforidentificationofepilepsy,ordrugssuchasinsulinoramphetamines.Quickneurologicandfunduscopicexaminationisindicatedtoruleoutbraintrauma,braintumor,etc.Thepresenceofhypertension,edemaandproteinuriaallindicateaneclampticseizure.（摘自　RICHRDH.SCHWARZ,M.D.etc.HandbookofObstetricemergencies.Medicalexaminationpublishingcompany,inc.65-36FreshmeadowLaneFlushing,N.Y.11365.41.）