乙型肝炎孕产妇并发HELLP综合征15例临床分析

Clinical Study of 15 Cases of Hepatitis B Combined with HELLP Syndrome

目的分析乙肝孕产妇合并妊娠高血压疾病、HELLP综合征的临床表现及对母儿的影响,探讨有效的诊断和治疗方法。方法回顾性分析1999～2009年在我院诊治的乙肝孕产妇合并HELLP综合征的15例患者的妊娠结局和围生儿的预后。结果 15例中患者全部发生在产前,平均孕龄为34周,孕产妇严重并发症包括:胎盘早剥、弥散性血管内疑血(DIC)、产后出血、胎儿窘迫等。10例经剖宫产结束分娩,患者需要输血或血制品支持治疗。患者全部存活,围生儿死亡1例,为胎盘早剥所致。结论 HELLP综合征是一种严重的产科并发症,尤其对于肝病合并妊娠的患者容易误诊,延误治疗,所以早期诊断、适时终止妊娠、综合性治疗,尤其对肝病孕产妇的支持治疗,可改善其预后,争取良好的妊娠结局。

Objective To analyze the clinical presentation and the effects on both mothers and fetuses with HELLP syndrome in- duced hyregtensive disorder complicating pregrancy and to investigate the effective methods for diagnosis and treatment. Methods 15 ea- ses of HELLP syndroms were retrospectively analyzed on material and perinatal outcomes. Results In 15case of women with HELLP syn- drome,all of them presented antepartum HELLP. Mean gestational age at delivery was 34 weeks. Severe maternal complications included placental abruption,DIC,postpartum hemorrhage, fetal distress, et al. All of them underwent cesaresn section and required transfusions with blood or blood products. 1 case of perinatal death was related to placental abruption. Conclusion HELLP syndrome is a severe obstetric complication. Better prognosis may be achiveved by early diagnosis,synthetic therapy and optimal termination of pregnancy.