HELLP综合征合并急性肾功能衰竭10例分析

Analysis of 10 cases of hemolysis, elevated liver enzymes and low platelet syndrome associated with acute renal failure

目的探讨HELLP综合征合并急性肾功能衰竭(ARF)的临床特点、诊断、治疗和孕产妇及新生儿预后。方法对我院2005年1月-2008年12月以来HELLP综合征合并ARF的10例患者临床资料进行回顾性分析。结果多为妊娠期高血压疾病的并发症,以血压升高、恶心、呕吐、水肿、皮下淤斑或黏膜出血、少尿或无尿为特点,乳酸脱氢酶、转氨酶、血小板、血肌酐等均为诊断及监测疾病变化及预后的指标;在常规治疗HELLP的基础上及时终止妊娠、行血液净化治疗,是防止病情恶化降低孕产妇及围产儿死亡率的关键。结论HELLP综合征合并ARF发病急而凶险,早期诊断、综合治疗、及时终止妊娠及血液净化治疗是改善孕产妇及新生儿预后的关键。

Objective To study the clinical characteristics, diagnosis, treatment of hemolysis, elevated liver enzymes and low platelet （HELLP） syndrome associated with acute renal failure （ARF） and the prognosis of pregnant and maternal women and neonates. Methods The data about 10 clinical cases of HELLP syndrome associated with ARF admitted to our hospital in January 2005-December 2008 were retrospectively analyzed. Results HELLP syndrome was found to be a complication of hypertension of pregnancy characterized by elevated blood pressure, nausea, vomiting, edema, ecchymosis or mucous hemorrhage, oliguria or anuria. Some laboratory data, such as the lactic dehydrogenase, aminotransferase, blood creatinine levels and platelet count, could be used as its diagnostic, monitoring and prognostic indexes. The key points to prevent deterioration of the disease and to reduce the mortality of pregnant and maternal women and neonates are to terminate pregnancy and to give hemopurication therapy. Conclusion HELLP syndrome associated ARF is an acute and serious disease. The key points to prevent deterioration of the disease and to reduce the mortality of pregnant and maternal women and neonates are early diagnosis, comprehensive treatment, termination of pregnancy and hemopurication therapy.