妊娠合并毛细血管渗漏综合征的诊断和治疗

目的探讨妊娠合并毛细血管渗漏综合征（capillary leak syndrome，CLS）的临床特征及其诊断和处理方法。方法收集2004年1月至2008年1月我院产科收治的9例妊娠合并毛细血管渗漏综合征患者的-临床资料，分析其发病原因、临床表现、治疗措施及母婴并发症。结果（1）9例妊娠合并CLS患者均为重度子痫前期，其中6例发生急性左心衰；（2）均有不同程度胸、腹腔积液或心包积液，浮肿均≥＋＋＋；（3）均有严重低蛋白血症，血浆白蛋白均〈20g／L（治疗前），24小时尿蛋白均〉5g／L；（4）晚期流产1例，早产7例，且均有胎儿宫内生长受限（IUGR）；（5）经积极治疗后9例患者均好转出院，无1例死亡。结论早期诊断，合理治疗，适时终止妊娠，可减少妊娠合并CLS患者母婴并发症，改善围生期预后。

Diagnosis and treatment of pregnancy with capillary leak syndrome

Objective To study the clinical features, diagnosis and treatment of cases of pregnancy with capillary leak syndrome. Methods 9 cases of pregnancy with capillary leak syndrome in the past 4 years （from January, 2004 to January, 2008） had been reviewed, the etiology, clinical feature, treatment and complications had been analysed. Results （1） 9 cases of pregnancy with capillary leak syndrome were severe preeclampsia, 6 of them suffered from acute ventricular heart failure. （2） All of them had pleural effusion or pericardial effusion, edema ≥ ＋ ＋ ＋. （3） All of them had severe hypoproteinaemia, ALB 〈20g/L （before treatment）, 24-hr urine protein 〉5 g/L. （4） l case was late abortion, 7 cases were preterm labor, all had intrauterine growth retardation. （5） All cases left hospitaI with improvement of disease after positive treatment, nobody died. Conclusion Early diagnosis, suitable treatment and timely termination of pregnancy can decrease the complications and improve the outcome of perinatal maternal and fetal prognosis.