血浆置换在产后HELLP综合征治疗中的作用  

The role of plasma exchange in treatment of postpartum HELLP syndrome

作　　者：魏青[1] 宋淑荣[1] 李倪[1] 梁茜[1] 

机构地区：[1]天津市第三中心医院妇产科,300170

出　　处：《重庆医学》2017年第34期4799-4801,共3页Chongqing medicine

摘　　要：目的探讨血浆置换对产后HELLP综合征的临床治疗效果。方法选取2014年1月至2015年12月,该院收治的44例产后HELLP综合征患者作为治疗组,在常规治疗的基础上联合应用血浆置换;同时选取该院2012年1月至2013年12月收治的47例产后HELLP综合征患者作为对照组,进行常规治疗。在治疗前、治疗后检测血红蛋白(Hb)、血小板(PLT)、凝血酶原时间(PT)、血清天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、血清总胆红素(TBIL)、结合胆红素(DBIL)、血清乳酸脱氢酶(LDH)、血尿素氮(BUN)、肌酐(Cr)水平变化情况;同时比较两组患者住ICU时间,PLT、ALT、AST和LDH恢复时间。结果治疗后,治疗组患者PLT、AST、ALT、LDH的水平与对照组比较,差异有统计学意义(P<0.05);治疗组患者住ICU时间,PLT、ALT、AST和LDH的恢复时间均低于对照组(P<0.05)。结论血浆置换可以明显改善产后HELLP综合征患者的临床症状,提高治愈率。Objective To explore the clinical effect of plasma exchange on postpartum HELLP syndrome. Methods From January 2014 to December 2015,44 patients with postpartum HELLP syndrome were chosen as the treatment group which received conventional treatment combined with plasma exchange. And we selected 47 patients with postpartum HELLP syndrome as the control group from January 2012 to December 2013. Serum hemoglobin（Hb）, platelet（PLT）, prothrombin time（PT）, serum aspartate aminotransferase（AST） ,alanine aminotransferase（ALT）, serum total bilirubin（TBIL）, conjugated bilirubin（DBIL） and serum lactic dehydrogenase（LDH） ,blood urea nitrogen（BUN） and creatinine（Cr） level in patients with postpartum HELLP syndrome were detected before and after the treatment. The ICU stay, recovery time of PLT, ALT, AST, and LDH were compared between two group. Results After treatment,the levels of PLT,AST,ALT and LDH in the treatment group were significantly higher than those in the control group （P〈0.05）. The ICU stays and the recovery time of PLU,ALT,AST and LDH in the treatment group were significantly lower than the control group （P〈0.05）. Conclusion Plasma replacement can significantly improve the clinical symptoms of postpartum HELLP syndrome patients,improve the cure rate.

关 键 词：HELLP综合征 血浆置换 治疗 产后期 

分 类 号：R714.246[医药卫生—妇产科学]