妊娠期高血压并发HELLP综合征28例临床分析

目的：分析妊娠期高血压疾病并发HELLP综合征的临床表现及对母婴的影响,探讨有效的诊断和治疗方法。方法：对28例HELLP综合征进行回顾性分析,其中完全性HELLP 18例,部分性HELLP 10例,比较两组的实验室指标、临床表现、母婴并发症和分娩结局。结果：完全性HELLP组的乳酸脱氢酶等各项实验室指标显著高于部分性组。完全性HELLP组中,重度子痫前期占83%（15/18）,有特殊表现病例占61%（11/18）,部分性HELLP组中,重度子痫前期占30%（3/10）,有特殊表现病例占20%（2/10）,两组差异有显著性（P〈0.05）。两组围生儿死亡率无统计学差异。两组剖宫产率分别为89%（完全性HELLP组）和90%（部分性HELLP组）,差异无显著性（P〉0.05）。两组患者的血小板和肝功能均于产后24小时开始恢复,产后96小时血小板恢复正常,产后第五天肝功能恢复正常。结论：完全性HELLP综合征的临床病情较部分性更加严重。但如能及时诊治,二者的预后差异无显著性。

Clinical study of 28 cases of hypertensive disorder complicating pregnancy combined with HELLP syndrome

Objective:To analyze the clinical presentation and the effects on both mother and fetus of HELLP syndrome induced by hypertensive disorder complicating pregnancy and to investigate the effective methods of diagnosis and treatment.Methods:28 cases of HELLP syndrome were collected retrospectively including 18 cases of complete HELLP syndrome and 10 partial HELLP syndrome.The blood test,clinical presentations,complications and pregnant outcomes were analyzed.Results:Blood test value in complete HELLP group was significantly higher than that in partial HELLP gorup.The number of severe preeclampsia and special presentation were significantly higher in complete HELLP group than those in partial HELLP gorup.No significant difference was found between the two groups in perinatal mortality and cesarean section rate.Conclusion:Clinical presentation and complications in complete HELLP group were more severe than those in partial HELLP gorup.The prognosis is similar if the patients can be diagnosed and treated timely.