HELLP综合征37例临床分析

Clinical analysis of diagnosis and treatment of 37 patients with HELLP syndrome

目的探讨HELLP(hemolysis,elevated liver enzymes,and low platelets,HELLP)综合征的诊断及治疗。方法对我院自2007-07～2010-12分娩的37例HELLP综合征患者进行回顾性分析。结果 HELLP综合征患者占同期分娩数的0.09%;治愈36例,转院1例,分娩时孕周(37±3.57)周;新生儿存活34例,死亡1例,胎死宫内2例。HELLP综合征患者的早产、剖宫产、胎盘早剥、DIC以及围生儿死亡发生率均显著高于同期分娩患者,其差异均有统计学意义;而对于完全性、部分性HELLP及并发轻度子痫前期、重度子痫前期患者分别进行相关的实验室数据分析,差异均无统计学意义。结论 HELLP综合征严重危胁母儿安全,要早诊断、治疗,适时终止妊娠,可有效改善母儿预后。

Objective To summarize the experience of the diagnosis and treatment of patients with hemolysis,elevated liver enzymes, and low platelets（HELLP） syndrome. Methods The clinical data of 37 patients with HELLP syndrome were analyzed retrospectively from July 2007 to December 2010. Results The incidence of HELLP syndrome was 0.09% in all labor patients. The pregnancies were terminated at 37±3.57 weeks of gestation. A total of 34 babies survived,and 3 babies died. The rates of early preterm,cesarean section, placental abruption, disseminated intravascular coagulation, perinatal death in HELLP group were higher than those in the other labor patients （ P 〈 0.05 ）. There was no significant difference in laboratory indices between complete and partial HELLP syndrome patients,and between HELLP patients with mild and severe preeclampsia. Conclusion HELLP syndrome is a serious life-threatening complication during pregnancy. Early diagnosis, early treatment and timely termination of pregnancy can improve the maternal and neo- natal outcome.