病例03(2024):产后溶血性尿毒综合征1例  

Case 03(2024):A case of postpartum hemolytic uremic syndrome

作　　者：杨红英 冯烨[2] 李东言 魏玉梅[2] 赫英东[2] 张广意 任志菲 常聪慧 赵静[1] 周福德[3] 李楠[4] 耿妍[5] 王文生[6] 王茫桔[6] 丁欢[7] 田娜[8] 马淑琴[9] 孙伟杰[2] 杨慧霞[2] Yang Hongying;Feng Ye;Li Dongyan;Wei Yumei;He Yingdong;Zhang Guangyi;Ren Zhifei;Chang Conghui;Zhao Jing;Zhou Fude;Li Nan;Geng Yan;Wang Wensheng;Wang Mangju;Ding Huan;Tian Na;Ma Shuqin;Sun Weijie;Yang Huixia(Department of Obstetrics,Ningxia Maternal and Child Health Hospital,Peking University First Hospital(Ningxia Hui Autonomous Region Maternal and Child Health Hospital),Yinchuan 750011,China;Department of Obstetrics&Gynecology and Reproductive Medicine,Peking University First Hospital,Beijing 100034,China;Department of Nephrology,Peking University First Hospital,Beijing 100034,China;Department of Intensive Care Medicine,Peking University First Hospital,Beijing 100034,China;Department of Rheumatology and Immunology,Peking University First Hospital,Beijing 100034,China;Department of Hematology,Peking University First Hospital,Beijing 100034,China;Department of Intensive Care Medicine,General Hospital of Ningxia Medical University,Yinchuan 750011,China;Department of Nephrology,General Hospital of Ningxia Medical University,Yinchuan 750011,China;Department of Rheumatology and Immunology,General Hospital of Ningxia Medical University,Yinchuan 750011,China)

机构地区：[1]北京大学第一医院宁夏妇女儿童医院(宁夏回族自治区妇幼保健院)产科,银川750011 [2]北京大学第一医院妇产生殖医学中心,北京100034 [3]北京大学第一医院肾内科,北京100034 [4]北京大学第一医院重症医学科,北京100034 [5]北京大学第一医院风湿免疫科,北京100034 [6]北京大学第一医院血液科,北京100034 [7]宁夏医科大学总医院重症医学科,银川750011 [8]宁夏医科大学总医院肾内科,银川750011 [9]宁夏医科大学总医院产科,银川750011

出　　处：《中华围产医学杂志》2024年第4期322-327,共6页Chinese Journal of Perinatal Medicine

摘　　要：本文报告了1例足月妊娠因重度子痫前期行剖宫产,术后出现产后溶血性尿毒综合征(postpartum hemolytic uremic syndrome,pHUS)的病例。患者孕39周因重度子痫前期在北京大学第一医院宁夏妇女儿童医院行急诊剖宫产,术后即刻发生微血管病性溶血性贫血、血小板减少、乳酸脱氢酶升高、肝功能异常(转氨酶及胆红素升高)、肾功能异常(少尿、血尿及肌酐进行性升高)。经多学科会诊,考虑重度子痫前期并发pHUS,需行血液透析及血浆置换治疗,转诊至宁夏医科大学总医院。经血液透析及血浆置换治疗,患者病情好转出院。出院后定期肾内科随诊,肾功能术后1个月恢复正常。This article reported a case of postpartum hemolytic uremic syndrome(pHUS)following cesarean delivery due to severe preeclampsia in a full-term pregnancy.The patient,at 39 weeks of gestation with severe preeclampsia,underwent an emergency cesarean section at the Ningxia Maternal and Child Health Hospital Peking University First Hospital.Immediately postoperatively,the patient developed microangiopathic hemolytic anemia,thrombocytopenia,elevated lactate dehydrogenase,abnormal liver function(increased transaminase and bilirubin),and renal dysfunction(oliguria,hematuria,and progressively rising creatinine levels).After multidisciplinary consultation,severe preeclampsia complicated by pHUS was considered,and the patient was referred to the General Hospital of Ningxia Medical University.Following hemodialysis and plasma exchange treatment,the patient's condition improved.She was discharged and continued to have regular nephrology follow-ups.The renal function returned to normal one month after surgery.

关 键 词：产后溶血性尿毒综合征 重度子痫前期 HELLP综合征 妊娠 

分 类 号：R714.6[医药卫生—妇产科学]