重度子痫前期患者发生产后溶血性尿毒综合征的危险因素分析  

Risk factor analysis of postpartum hemolytic uremic syndrome in patients with severe preeclampsia

作　　者：武园歌 张媛[2] 徐永萍[1] 辛刚[1] 徐帅 洪凡真[1] Wu Yuange;Zhang Yuan;Xu Yongping(Department of Obstetric;Center of Evidence-based Medicine,The Second Hospital of Shandong University,Jinan 250033)

机构地区：[1]山东大学第二医院产科,济南250033 [2]山东大学第二医院循证医学中心,济南250033

出　　处：《现代妇产科进展》2018年第8期602-604,共3页Progress in Obstetrics and Gynecology

基　　金：山东省自然科学基金(No:ZR2014HP029);山东省科学技术发展计划(No:2013GSF11810)

摘　　要：目的:探讨重度子痫前期(PE)患者发生产后溶血性尿毒综合征(PHUS)的临床危险因素,为重度PE的早期预防提供依据。方法:收集发生PHUS的重度PE患者6例和未发生PHUS的重度PE患者24例,记录一般资料、实验室检查、术中情况、麻醉用药和临床用药情况,采用t检验、非参数检验和χ~2检验进行单因素分析。结果:PHUS组水肿≥++占83.3%,尿蛋白≥+++占100%。水肿≥++、腹水、视网膜动静脉比缩小、尿素氮和肌酐值位于正常范围上限、尿蛋白≥+++、术后白细胞和中性粒细胞百分比明显升高可能是重度PE患者发生PHUS的危险因素。结论:对于重度PE患者,应高度警惕PHUS发生,并针对上述可疑高危因素实施重点防护,以降低PHUS的病死率及改善预后。Objective： To explore the clinical risk factors of postpartum hemolytic uremic syndrome（ PHUS） in patients with severe pre-eclampsia,and provide basis for early prevention of this disease. Methods： 6 patients with severe preeclampsia patients occurred PHUS and 24 patients without PHUS were collected. The general data,laboratory examination,intraopercitive conditions,narcotic drugs and clinical medicine were recorded,using t-test,non-parametric test and chi-square test on the single factor analysis of two groups of data.Result： Edema≥＋＋,ascites,retinal arterial venous ratio shrinks,urea nitrogen and creatinine value were at the upper limit of the normal range,urinary protein≥ ＋ ＋ ＋,postoperative white blood cell and neutrophils percentage obvious rise may be risk factors for PHUS in patients with severe preeclampsia.In the PHUS group,edema≥＋ ＋ accounted for 83.3%,and urine protein≥ ＋ ＋ ＋ accounted for 100%.Conclusions： Patients with severe preeclampsia should be highly alert to the occurrence of PHUS and focused on the above suspected risk factors to reduce the mortality of PHUS and improve the prognosis.

关 键 词：产后溶血性尿毒综合征 重度子痫前期 危险因素 

分 类 号：R714.258[医药卫生—妇产科学]