HELLP综合征68例的临床观察及治疗

Clinical Observation and Treatment of HELLP Syndrome in 68 Cases

目的探讨妊娠高血压疾病并发HELLP综合征的诊治。方法随机抽取2012年3月—2014年10月该院收治的HELLP综合征患者68例,回顾分析病例,通过患者的HELLP综合征临床表现、并发症、分娩等情况进行观察,通过部分性与完全性的HELLP综合征进行对比。结果所有患者的HELLP综合征有着不同程度的妊娠高血压疾病表现,如水肿、高血压、蛋白尿等。一般发病周期为28~39周,平均周期(34±1),其中剖宫产有35例,正常分娩有33例,部分性HELLP综合征为28例,完全性HELLP综合征为40例,两组患者的综合症状比较差异无统计学意义(P>0.05)。产妇并发症:8例急性肾衰竭,12例胎盘早剥,8例产后出血,4例低蛋白血症,7例为子痫前期轻度,8例为子痫前期重度,29例早产。1例胎死宫内,其死亡率为1.47%。结论 HELLP综合征是影响母婴安全的一种并发症,早期发现和及时治疗HELLP综合征,可以有效的减少母婴死亡的发生。

Objective To observe the diagnosis and treatment of the pregnancy-induced hypertension disease complicated with HELLP syndrome. Methods 68 patients with HELLP syndrome admitted to this hospital between March 2012 and October 2014 were randomly selected and retrospectively. Their clinical manifestations, complications, delivery etc were observed and compared between those with partial and complete HELLP syndrome. Results All the patients with HELLP syndrome were featured with disease related to pregnancy-induced hypertension, such as edema, hypertension and proteinuria, etc. The course of disease was 28-39 weeks, averaging(34±1) weeks. 35 patients underwent cesarean section and 33 normal delivery. There were 28 cases of partial HELLP syndrome and 40 cases of complete HELLP syndrome, but there were no statistically significant differences in comprehensive symptom between the two groups, P >0.05. The complications included 8 cases of acute renal failure, 12 cases of placental abruption, 8 cases of postpartum hemorrhage, 4 cases of hypoalbuminemia, 7 cases of mild preeclampsia, 8 cases of severe preeclampsia, 29 cases of premature delivery. There was 1 case of fetal intrauterine death with mortality rate of 1.47%. Conclusion HELLP syndrome is a kind of complication which can influence maternal and child safety, and early detection and timely treatment for this complication can effectively reduce maternal and infant death.