妊娠合并HELLP综合征的临床研究进展

Clinical Progress of Pregnancy Complicated with HELLP Syndrome

HELLP综合征(hemolysis, elevated liver enzymes, and low platelet count syndrome, HELLP syn-drome)是子痫前期的严重阶段,主要表现为溶血、肝酶升高和血小板减少,可引起多脏器功能障碍,对母婴危害极大,是孕产妇和围产期发病率和死亡率的重要原因之一。尽管国内外对于HELLP综合征的认识在不断加深,但其发病机制尚未完全明确,且临床表现往往呈现非典型、临床多样化,病情发展快,容易误诊、漏诊。使用糖皮质激素、补充血制品及适时终止妊娠是治疗HELLP综合征的重要方法。本文就其发病机制、临床表现、诊断标准、鉴别诊断、治疗方案等方面作一综述,便于在临床工作中引起重视、及早处理、改善预后。

HELLP syndrome is a severe stage of preeclampsia, mainly characterized by hemolysis, elevated liver enzymes and thrombocytopenia, which can cause multiple organ dysfunction and great harm to maternal and infant, and is one of the important causes of maternal and perinatal morbidity and mortality. Despite the deepening understanding of HELLP syndrome at home and abroad, the pathogenesis of HELLP syndrome is not completely clear, and its clinical manifestations are often atypical and clinical diversification, with rapid disease development and easy misdiagnosis and missed diagnosis. The use of glucocorticoids, blood supplement and timely termination of pregnan-cy are important methods for the treatment of HELLP syndrome. In this paper, the pathogenesis, clinical manifestations, diagnostic criteria, differential diagnosis and treatment are reviewed in or-der to improve the prognosis and arouse attention in clinical work.