中华危重病急救医学2023年1月第35卷第1期Chin Crit Care Med,January2023,Vol.35,No.1。5·专家共识《中国心肺复苏专家共识》之孕产妇心搏骤停防治救指南米玉红周飞虎王立祥李银平孟庆义张军张馨予通信作者：米玉红，Email:myhicut@163.com;周飞虎，Email:zhoufeihu(@163.com;王立祥，Email:wjwx@163.com【摘要】孕妇作为特殊时期的一组人群，一旦出现突发心搏骤停(CA)会威胁到母子两人的生命。最大限度地降低孕产妇死亡，确保围产期母子全程平安，成为医疗机构和医护人员要面对的巨大挑战。与相同年龄普通CA患者的心肺复苏施救策略不同，孕期CA患者施救需要考虑患者的孕龄、胎儿情况等，采用不同的复苏手法如左推子宫(MLUD),会涉及濒死剖宫产(PMCD):同时针对导致孕期CA的不同原因如出现4Hs中的低氧血症、低血容量、高血钾或低血钾及其他电解质紊乱、低体温，以及4Ts中的血栓形成、心包填塞、张力性气胸和中毒等情况的合理药物应用。针对导致孕期CA的原因中多种情况为可预防性的特点，更有必要出台符合我们国情的孕期CA指南以指导临床。本文系统梳理了孕期CA的病理生理特点，孕期CA的高危因素，明确了孕期CA的正确复苏方法和防治策略。【关键词】孕期：心搏骤停：心肺复苏：病因：预防D0I:10.3760/cmaj.cn121430-20221208-01074Chinese consensus of cardiopulmonary resuscitation guides prevention,treatment and rescue of cardiac arrestin pregnancyMi Yuhong,Zhou Feihu,Wang Lixiang,Li Yinping,Meng Qingyi,Zhang Jun,Zhang XinyuCorresponding author:Mi Yuhong,Email:myhicu@163.com;Zhou Feihu,Emaik zhoufeihu@163.com:Wang Lixiang,Email:wigwlx@163.com[Abstract Pregnant women are a group of people in a special period,once sudden cardiac arrest (CA)occurs,it will threaten the life of both mother and child.It has become a great challenge for hospital,doctors and nursesto minimize maternal mortality during pregnancy.All the efforts should ensure the safety of both mother and childthroughout the perinatal period.Because difference of the cardiopulmonary resuscitation strategies for common CApatients of the same age,the resuscitation strategies for CA patients during pregnancy need consider the patient'sgestational age and fetal condition.Different resuscitation techniques,such as manual left uterine displacement(MLUD),will involve perimortem cesarean delivery (PMCD).At the same time,drugs should be reasonably used for differentcauses of CA during pregnancy,such as hypoxemia,hypovolemia,hyperkalemia or hypokalemia and other electrolytedisorders and hypothermia in 4Hs,as well as thrombosis,pericardial tamponade,tension pneumothorax and toxicosis in4Ts.In view of the fact that many causes of CA in pregnancy are preventable,it is more necessary to introduce guidelinesfor CA in pregnancy in line with our national conditions for clinical guidance.This paper systematically reviewed thepathophysiological characteristics of CA during pregnancy,the high-risk factors of CA during pregnancy,and identifiedthe correct resuscitation methods and prevention and treatment strategies of CA during pregnancy.[Key words]Pregnancy;Cardiac arrest:Cardiopulmonary resuscitation:Etiology:PreventionD0L:10.3760emaj.cm121430-220221208-01074孕妇作为特殊时期的一组人群，尽管出现突发剖宫产(perimortem cesarean delivery,PMCD)术及是心搏骤停(cardiac arrest,CA)概率非常低，但因会殃否取舍胎儿等都是孕期CA需要关注的重要问题。及到母子两人的生命，危害性极大[。最大限度地我国二胎政策的放开、大龄或者高危妊娠数量随之降低孕、产妇死亡率，确保围产期母子全程平安成增加，迫切需要出台孕期CA相关的诊疗规范。欧为医疗机构和医护人员面对的巨大挑战。幸运的是，洲心脏病协会(European Society of Cardiolog,ESC）导致孕期CA的原因中多种情况是可以预防，甚至在2003年曾经出台了孕期心血管疾病管理[3]，并先是可以有效避免的。孕妇出现CA的准确识别、有后于2011年[41和2018年[5从不同角度，如诊断技效的气道管理及结合手动将子宫推向左侧（左推子术、危险分层、心血管药物应用等循证医学证据做宫，即manual left uterine displacement,MLUD)的精出进一步的更新。我国目前尚缺乏有说服力的、系
