妊娠并发HELLP综合征66例临床分析  

Clinical analysis of 66 cases with HELLP syndrome

作　　者：贺芳[1,2] 陈敦金[1,2] 

机构地区：[1]广州医学院附属第三医院 [2]广州市重症孕产妇救治中心,广东广州510150

出　　处：《中国实用妇科与产科杂志》2012年第5期388-390,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨妊娠并发HELLP综合征的临床特点及孕产妇和围产儿的预后。方法回顾性分析2005年1月至2009年12月在广州医学院附属第三医院妊娠合并HELLP综合征66例,比较完全性和部分性HELLP患者的实验室指标、入院孕周、终止妊娠时机、围产儿缺氧、出生体重及死亡率等。结果实验室指标:完全性HELLP组血小板计数明显低于部分性HELLP组(P<0.05),乳酸脱氢酶(1651.8±1058.9)U/L则显著高于部分性HELLP组(478.3±266.6)U/L(P<0.05);天冬氨酸转氨酶及总胆红素两组间亦存在显著统计学差异(P<0.05)。完全性HELLP组的分娩孕周为(33.7±4.0)周,新生儿体重(1723.8±546.1)g,死亡率为14.3%;部分性HELLP组的分娩孕周为(34.2±4.2)周,新生儿体重(1831.2±949.3)g,死亡率为14.3%,两组间无统计学差异(P>0.05)。结论完全性HELLP综合征和部分性HELLP综合征在实验室指标、临床表现方面均有显著不同。如能早期诊断、早期支持治疗并应用糖皮质激素,依据病情的严重程度及孕周,及时终止妊娠,新生儿的预后无显著差异。Objective To explore the clinical features of Hemolysis,Elevated liver enzymes and Low platelets syndrome, maternal and neonatal prognosis with HELLP syndrome. Methods 66 cases of HELLP syndrome in the Third Affiliated Hospital of Guangzhou Medical College between Jan. 2005 and Dec. 2009 were collected retrospectively including 43 cases of complete HELLP syndrome and 23 partial HELLP syndrome. The blood test, mode of delivery and pregnant outcomes were analyzed. Results LDH value in complete HELLP group （ 1651.8 ± 1058. 9 ） U/ L was significantly higher than that in partial HELLP group （478. 3 ±266. 6） U/L,P 〈 0. 05. Laboratory values including platelets, AST and total bilirubin were significant differences between complete HELLP group and partial HELLP group （ P 〈 0. 05 ）. There were no significant differences between the gestational age and neonatal birth weight in complete HELLP group and partial HELLP group [ （33.7±4.0） wks vs. （34. 2 ±4. 2） wks, （ 1723.8 ±546. 1 ） g vs. （ 1831.2 ±949. 3）g,P 〉0. 05]. Conclusion Complete HELLP syndrome was significantly different from partial HELLP syndrome in lab values and clinical manifestations. If adopting clinical measures of women with HELLP syndrome such as early diagnosis, early supportive treatment, using glycocorticoid and ending the pregnancy timely according to patient＇ s condition, the approach to a neonatal prognosis was no difference.

关 键 词：妊娠 妊娠期高血压疾病 HELLP综合征 

分 类 号：R714.24[医药卫生—妇产科学]