镜像综合征8例临床分析  

Clinical analysis of 8 cases with mirror syndrome

作　　者：王马列[1] 梁润彩[1] 

机构地区：[1]中山大学附属第一医院妇产科,广东广州510080

出　　处：《中国实用妇科与产科杂志》2014年第5期369-373,共5页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨镜像综合征的临床特征及治疗方法。方法回顾性分析2007年8月至2012年5月于中山大学附属第一医院收治的8例镜像综合征患者临床资料,包括母体一般情况、实验室检查指标及超声检查、产后大体检查、胎盘病理及母儿围产结局。结果镜像综合征的临床表现以母体水肿、高血压、蛋白尿、稀释性贫血、低蛋白血症、胎儿水肿及胎盘水肿为特征。严重者出现胸水、腹水、肺水肿和心衰。此类患者产后出血、输血、转重症监护病房比例高。本组8例分娩前血红蛋白(HB)、红细胞压积(HCT)及血白蛋白(ALB)均降低,分别为(77.38±9.10)g/L、0.246±0.029及(24.86±3.10)g/L;终止妊娠后HB、HCT及ALB明显改善,分别为(99.27±15.27)g/L、0.308±0.046及(29.59±3.13)g/L,分娩后与分娩前相比较差异有统计学意义(P<0.05)。8例患者终止妊娠后母体症状迅速改善并全部痊愈出院。结论镜像综合征与子痫前期诊断易混淆,其中稀释性贫血是鉴别诊断要点。确诊镜像综合征后,可予纠正低蛋白血症和合理使用利尿剂,严格限制液体入量,尽早终止妊娠,预防产后出血等处理。终止妊娠是治疗镜像综合征的根本方法。Objective To approach the clinical features and treatment of mirror syndrome. Methods The clinical data including general state of mother nuclide, laboratory and ultrasound examination, gross and microscopic placental examina- tion and outcomes of both mother and fetus in 8 cases with mirror syndrome at our hospital from August 2007 to May 2012 were analyzed retrospective. Results The clinical features of mirror syndrome include maternal edema, hypertension, proteinuria, dilution anemia, hypoproteinemia, hydrops fetalis and hydropic placenta. The severe patient would appear pleural fluid,ascites, pulmonary edema and congestive heart failure. The patient have a large proportion of postpartum hemorrhage, transfusion and being treated in the intensive care unit. Eight cases have several characteristics such as ane- mia and hemodilution [ HB （77. 3 ± 9. 10） g/L and HCT 0. 246 ± 0. 029 ], hypopoteinemia [ ALB （ 24. 86 ± 3. 10 ） g/L ], and the hemoglobin, hamat and albumin were elevated significantly [ HB （99. 27 ± 15.27 ） g/L, HCT 0. 308 ± 0. 046, ALB （29. 59 ± 3.13 ）g/L] after termination of pregnancy. Eight cases recovered increasingly after termination of pregnancy. Conclusion Itg easy to confuse the diagnose between mirror syndrome and preeclampsia. Maternal dilution anemia is an important characteristic. Once mirror syndrome is diagnosed,the treatment should be considered including to correct hy- popoteinemia, use diuretic agent, control the imput fluid and prevent postpartum hemorrhage. Termination of pregnancy is the basic treatment of mirror syndrome.

关 键 词：母体水肿 胎儿水肿 胎盘水肿 镜像综合征 

分 类 号：R71[医药卫生—妇产科学]