溶血、肝酶升高及血小板减少综合征早期诊治及围产母儿结局分析  

Early diagnosis of hemolysis,elevated liver enzymes,and low platelets syndrome during pregnancy and analysis of perinatal maternal and fetal outcomes

作　　者：林志新[1] 夏红卫[1] 贝为武[1] 莫诒芬[1] 

机构地区：[1]广西壮族自治区妇幼保健院妇产科,南宁530003

出　　处：《上海医学》2010年第10期938-941,共4页Shanghai Medical Journal

摘　　要：目的探讨妊娠高血压疾病并发溶血、肝酶升高及血小板减少(HELLP)综合征的早期诊断及处理对围产母儿结局的影响。方法收集并分析2007年1月—2009年4月在广西壮族自治区妇幼保健院住院发生HELLP综合征的12例孕产妇资料。结果 HELLP占重度子痫前期和子痫的8.33%(12/144),占同期住院分娩的0.15%(12/7793)。11例在产前发生,发生急性肾功能衰竭、胎盘早剥各2例,弥散性血管内凝血1例,术后并发脑出血1例,新生儿窒息8例,无1例孕产妇及围产儿死亡。结论认识HELLP综合征的临床特点,动态监测溶血、血小板、肝酶及凝血相关实验室指标有助于早期诊断和减少误诊。适时终止妊娠是控制HELLP综合征病情恶化,并改善母儿预后的关键。Objective To investigate the diagnosis and treatment of pregnancy-induced hypertension complicated hemolysis,elevated liver enzymes,and low platelets（HELLP）syndrome and its influence on perinatal maternal and fetal outcomes.Methods The clinical data of 12 pregnant women who also had HELLP syndrome were collected in our hospital during Jan.2007—April.2009.Results The incidence of HELLP syndrome was 8.33%（12/144）in the patients with severe pre-eclampsia and eclampsia,and 0.15%（12/7 793）in all the pregnant women in our hospital.Eleven of the 12 patients（91.67%）developed HELLP syndrome before delivery.Acute renal failure and premature separation of placenta were each found in two cases,diffuse intravascular coagulation（DIC）in one case,post-operation cerebral hemorrhage in one case,asphyxia of newborn in 8 cases,and there was no perinatal maternal or neonatal deaths.Conclusion Knowing the clinical characteristics of HELLP syndrome and dynamic monitoring of the hemolysis,platelet,liver enzyme,and coagulation related parameters can help the early diagnosis and reduce misdiagnosis of HELLP syndrome.Timely termination of pregnancy is the key to prevent the deterioration of the syndrome and to improve the outcomes of pregnancy.

关 键 词：溶血、肝酶升高及血小板减少综合征 重度子痫前期 诊断 治疗 围产结局 

分 类 号：R714.7[医药卫生—妇产科学]