重度妊娠高血压疾病并发HELLP综合征病例分析  

Aanlysis of severe hypertensive disorders in pregnancy complicated with HELLP syndrome

作　　者：李娈英[1] 

机构地区：[1]河南省漯河市第三人民医院妇产科,462000

出　　处：《中国实用医刊》2016年第5期74-75,共2页Chinese Journal of Practical Medicine

摘　　要：目的探讨重度妊娠高血压并发HELLP综合征的临床特点、治疗及预后。方法回顾性分析2013年7月至2014年7月漯河市第三人民医院收治的43例重度妊娠高血压并发HELLP综合征患者的临床资料，将其中合并I级HELLP综合征的22例患者设为观察组，将另外21例Ⅱ级HELLP综合征的22例患者设为对照组，对比两组生化指标及母婴结局差异。结果两组天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、血小板计数（PLT）比较差异未见统计学意义（P〉0．05），但观察组乳酸脱氢酶（LDH）水平明显高于对照组（P〈0．05）。两组剖宫产发生率比较差异未见统计学意义（P〉0．05），但观察组产妇并发症、围生儿并发症、早产和围生儿死亡率等指标方面均高于对照组（P〈0．05）。结论HELLP综合征是重度妊娠高血压患者较为严重的并发症之一，其中Ⅰ级妊娠高血压合并HELLP综合征程度较Ⅱ级严重，应强化术前检查，必要时终止妊娠，以降低母婴死亡率。Objective To investigate the clinical features, treatment and prognosis of severe hypertensive disorders in pregnancy complicated with HELLP syndrome. Methods From July 2013 to July 2014 in the third people＇ s hospital of Luohe, the clinical data of 43 patients with severe pregnancy-induced hypertension complicated with HELLP syndrome were retrospectively analyzed. The 22 patients with grade I HELLP syndrome were in observation group, and another 21 patients with grade U HELLP syndrome were in control group. The biochemical markers and maternal outcome were compared between the two groups. Results There was no significant difference in aspartate aminotransferase （AST）, alanine aminotransferase （ALT） or platelet count （PLT） between the two groups （ P 〉 0. 05 ）, but the level of lactate dehydrogenase （LDH） was significantly higher in the observation group than that in the control group （ P 〈 0.05 ）. There was no significant difference in caesarean section incidence between the two groups （P 〉 0. 05 ）, but the maternal complications and perinatal complications, premature birth and perinatal mortality in the observation group were higher than that in the control group （ P 〈 O. 05 ）. Conclusions HELLP syndrome is a severe complication in patients with severe pregnancy-induced hy- pertension, gestational hypertension complicated by grade Ⅰ HELLP syndrome is more severe than gestational hypertension complicated by grade Ⅱ HELLP syndrome, so it should strengthen the preoperative examination, terminate pregnancy if necessary, in order to reduce maternal and child mortality.

关 键 词：重度 妊娠高血压 HELLP综合征 妊娠 预后 

分 类 号：R714.246[医药卫生—妇产科学]