29例HELLP综合征临床分析

目的探讨妊娠期高血压疾病并发溶血、肝酶升高及血小板减少综合征(HELLP综合征)的发病及各项指标在早期诊断中的作用。方法对2000年1月～2006年6月确诊的HELLP综合征患者的临床资料进行回顾性分析。结果HELLP综合征多发生于孕34~ 周左右,大部分有腹痛、恶心、呕吐等主诉,可出现胎盘早剥、急性肾功能衰竭、急性心功能衰竭、弥散性血管内凝血等并发症。血小板的动态变化可能是最早提示疾病发生的指标,而肝酶和乳酸脱氢酶(LDH)是反映病情变化趋势的可靠指标。新生儿的预后主要与终止妊娠时的孕周有关。结论HELLP综合征病情凶险,成功治疗HELLP综合征的关键在于早期诊断、早期治疗、及时终止妊娠,降低并发症的发生率及母婴的死亡率。

A Report of 29 Cases with Hemolysis,Elevated Liver Enzymes and Low Platelet Count (HELLP) Syndrome

Objective To summarize the incidence of patients with hemolysis,elevated liver enzymes and low platelet count(HELLP) syndrome.Methods The clinical data of 29 cases with HELLP syndrome were analyzed retrospectively during the past 6 years.Results HELLP syndrome happened around 34 weeks gestation.Most of patients had the complains of abdominal pain,nausea,emesis,and the complications of placental abruption,acute renal failure,acute heart failure,disseminated intravascular coagulation.The developmental change of platedlet count is probably the earliest index to indicate the incidence of the syndrome,while liver enzymes and LDH are the most reliable indexes reflecting the patients' condition.The prognosis of the neonates was related to the terminal gesta- tional age.Conclusion HELLP syndrome is serious and life-threatening.In order to decrease the maternal and perinatal mortality rate and the incidence rate of the complications,HELLP syndrome should be diagnosed and treated as fast as plssible,and terminate the pregnant in the right time.