探讨妊娠期高血压疾病并发HELLP综合征的临床特点及母婴结局

Clinical characteristics and maternal-infant outcomes of hypertensive disorder complicating pregnancy complicated with HELLP syndrome

目的探讨妊娠期高血压疾病并发HELLP综合征的临床特点及母婴结局,旨在为临床治疗提供参考依据。方法选取2014年6月-2016年6月该院收治的妊娠期高血压疾病并发HELLP综合征患者38例,其中20例为完全性HELLP综合征,18例为部分性HELLP综合征,通过对两种不同类型HELLP综合征患者的临床资料进行回顾性分析,以对两组患者的临床特点及母婴结局进行比较。结果与部分性HELLP综合征患者比较,完全性HELLP综合征患者丙氨酸转氨酶(ALT)、天门冬氨酸氨基转氨酶(AST)水平均明显升高(P<0.05),但两组患者血小板(PLT)、乳酸脱氢酶(LDH)水平比较,差异均无统计学意义(P>0.05);与部分性HELLP综合征患者比较,完全性HELLP综合征患者重度子痫和子痫前期发生率及新生儿死亡率均明显升高(P<0.05),但在产妇并发症和剖宫产发生率方面,两组间差异无统计学意义(P>0.05)。结论妊娠期高血压疾病并发HELLP综合征发病急骤、凶猛,严重影响母婴健康,且完全性HELLP综合征对孕产妇的危害更为严重,临床上应做到早期识别并给予及时有效的治疗,以对孕妇及新生儿预后加以改善。

Objective To explore the clinical characteristics and maternal-infant outcomes of hypertensive disorder complicating pregnancy （HDCP） complicated with HELLP syndrome,provide a reference basis for clinical treatment.Methods Thirty-eight patients with HDCP complicated with HELLP syndrome treated in the hospital from June 2014 to June 2016 were selected,20 patients with complete HELLP syndrome and 18 patients with partial HELLP syndrome were included.The clinical data of the patients with two types of HELLP syndrome was analyzed retrospectively,then the clinical characteristics and maternal-infant outcomes were compared.Results Compared with the patients with partial HELLP syndrome,the levels of serum alanine aminotransferase （ALT） and aspartate aminotransferase （AST） in patients with complete HELLP syndrome increased significantly （P〈0.05）.There was no statistically significant difference in platelet count and lactic dehydrogenase level between the two groups （P〉0.05）.Compared with the patients with partial HELLP syndrome,the incidence rates of severe preeclampsia and eclampsia and neonatal mortality in patients with complete HELLP syndrome increased significantly （P〈 0.05）.There was no statistically significant difference in maternal complications and cesarean section rate between the two groups （P〉 0.05）.Conclusion The onset of HDCP complicated with HELLP syndrome is rapid and fierce,which seriously affects maternal-infant health,and the harm of complete HELLP syndrome is more serious compared with partial HELLP syndrome.Early detection,timely and effective clinical treatment can improve maternal-infant prognosis.