HELLP综合征16例临床分析

HELLP(Hemolysis,Elevated Liver Enzymes,and Low Platelets) Syndrome:An Analysis of 16 Cases

目的探讨子间前期并发HELLP综合征的发病率、诊断、治疗及预后。方法对16例子间前期并发HELLP综合征患者的临床资料进行回顾性分析。结果完全性HELLP综合征14例,部分性HELLP综合征2例。治疗方法为严密监护母儿情况下积极治疗子间前期,早期使用糖皮质激素,适时终止妊娠。主要并发症为DIC、肝被膜下血肿、胎盘早剥、肺水肿和急性肾功能衰竭等。16例患者中死亡1例,围产儿死亡3例,死亡率分别为6.25%及18.75%。结论 HELLP综合征是子间前期的一种严重威胁母儿安全的并发症,早期诊断、综合性治疗、适时终止妊娠,可改善HELLP综合征患者的预后。

Objective To summarize the incidence, diagnosis, treatment and prognosis of hemol- ysis,elevated liver enzymes and low platelets （HELLP syndrome）. Methods Clinical data of 16 pati- ents with HELLP syndrome complicated by severe pregnancy-induced hypertension were analyzed retrospectively. Results Fourteen patients had complete HELLP syndrome and 2 patients had partial HELLP syndrome. The major therapeutic way for HELLP syndrome was intensive maternal and fetal monitoring, active management of preeclampsia and eclampsia, early use of corticosteroids, and timely termination of pregnancy. Major complications included disseminated intravascular coagulation, hepatic subcapsular hematoma, placental abruption, pneumonedema and acute renal failure. Maternal mortality and perinatal mortality were 6.25%（1 patient）and 18.75%（3 fetuses）,respectively. Conclusion HELLP syndrome is a serious life-threatening complication of severe pregnancy-induced hypertension. Early diagnosis, comprehensive treatment and timely pregnancy termination can improve prognosis in patients with HELLP syndrome.