产科危急重症 HELLP 综合征的急诊处理

The study of emergency treatment in critical pregnancy with HELLP syndrome

目的：回顾分析12例妊娠合并HELLP综合征的临床特点和母儿结局，探讨该病的早期诊断和急诊处理的方式。方法对2011－01-2013－12我院12例HELLP综合征患者的临床资料和母儿结局进行回顾性分析。结果12例HELLP综合征发病孕周为24-38周，终止妊娠孕周（31．6±4．1）周，10例剖宫产，2例阴道分娩；完全性HELLP 7例，部分性HELLP 5例。孕产妇严重并发症有：多脏器衰竭、DIC和心衰3例，胎盘早剥1例，产后出血3例；新生儿早产8例，重度窒息5例，轻度窒息1例，死亡2例。结论 HELLP综合征是一种严重的产科并发症，尤其是完全性HELLP综合征的患者，应及早诊断及早处理，急诊剖宫产终止妊娠是处理最有效的措施。

Objective To investigate the early diagnosis and opportunity emergency treatment of HELLP syndrome through analyzing the clinical data of 12 cases of HELLP syndrome .Methods Retrospective analysis was done in 12 cases of HELLP syndrome treated in Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University in recent three years .Results Twelve cases of HELLP syndrome were collected including 7 cases of complete HELLP syndrome and 5 cases partial HELLP syndrome.The PLT,AST,ALT and LDH had no significant difference in complete HELLP group and in partial HELLP group （P〉0.05）.The maternal complications included ascites , hypoproteinemia, DIC, renal failure, cerebral changes , eclampsia, postpartum hemorrhage .There was no maternal death . In the 12 cases including 10 cases cesarean section and 2 cases vaginaldelivery .No significant difference was found between the two groups in the gestation age and neonatal birth weight （P〉0.05）.Conclusion HELLP syndrome is a dangerous disease , and ought to be early diagnosed and emergently treated , especially for complete HELLP .Cesarean is the most effective treatment .