ICU收治重度子痫前期合并HELLP综合征的临床分析

蒋逸群; 谢云; 金卫; 田锐; 钱永兵; 李岩; 王瑞兰

doi:10.13201/j.issn.1009-5918.2017.06.006

ICU收治重度子痫前期合并HELLP综合征的临床分析

- 上海交通大学附属第一人民医院急诊危重病科(上海, 201620)

详细信息

通讯作者: 王瑞兰, E-mail:celia815@hotmail.com

中图分类号: R714.245

收稿日期: 2017-04-27

The analysis of correlation risk and prognostic factors on severe preeclampsia complicated with HELLP syndrome in ICU

- Department of Intensive Critical Care, General Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 201602, China

More Information

Corresponding author: WANG Ruilan, E-mail: celia815@hotmail.com

Received Date: 27 April 2017

摘要

摘要: 目的: 探讨重症医学科收治的重度子痫前期(SPE)并发HELLP综合征患者的危险因素、临床特征、预后和临床治疗分析,以期改善母婴预后。方法: 回顾性分析我院2007-01-2016-12 ICU收治的SPE患者125例,根据有无并发HELLP综合征分为HELLP组和非HELLP组,使用卡方检验和方差分析比较2组患者的一般资料、临床特征、治疗措施、预后等临床资料。结果: 125例SPE孕产妇中,并发HELLP综合征者26例,发生率为20.8%。经产妇、高龄及非规律产前检查易合并发生HELLP。2组间输血率、天冬氨酸转氨酶、丙氨酸转氨酶、总胆红素、肌苷、血糖、D-二聚体、血小板计数、新生儿Apgar评分(1、5、10 min)、ICU住院天数及成分输血比较差异均有统计学意义(P<0.05)。2组均无孕妇发生死亡,新生儿存活率比较差异无统计学意义。结论: 本研究中,SPE并发HELLP综合征患者中,经产妇、高龄、非规律产检是危险因素;孕期动态监测子痫前期患者外周血小板计数、D-二聚体、肝肾功能等指标,对预防和早期发现HELLP 综合征,降低母婴并发症及病死率有一定的价值。成分输血是治疗HELLP综合征的有效手段。
- 重度子痫前期 /
- HELLP综合征 /
- 危险因素 /
- 重症监护室
Abstract: Objective: To analyze the risk,clinical characteristics,prognostic factors,pregnancy outcomes and treatment on SPE (severe preeclampsia) complicated wtih HELLP (hemolysis,elevated liver enzymes,and low platelet count) Syndrome,which can help us to improve the outcomes of pregnant and fetus in ICU.Method: Retrospective study the clinical data of 125 patients with severe preeclampsia in ICU of Shanghai General Hospital from January 2007 to December 2016.26 cases of SPE complicated with HELLP syndrome.99 cases of SPE without HELLP syndrome were collected and analyzed retrospectively.General clinical data,laboratory data,treatment and pregnancy outcomes of patients and their fetuses were compared by chi-square test and ANOVA.Result: The patients were divided into two groups according to whether or not they had HELLP syndrome.The incidence of SPE complicated with HELLP was 20.8%.There were significant differences of aged,pregnancy history,prenatal check-up,platelet count,D-dimer,serum Cr,serum total bilirubin,serum AST,serum ALT,serum glucose,Apgar score,ICU LOS and transfusion of blood products between the two groups (P<0.05).No maternal death occurred in the two groups.No statistical difference was found between neonatal survival rate.Conclusion: Aged,pregnancy history,prenatal check-up are risk factors,which were related to the SPE with HELLP syndrome.Enhancing the antenatal care and dynamic monitoring laboratory data such as complete blood count,hepatic function,renal function,and coagulation function of preeclampsia patients,which are useful to discover HELLP syndrome earlier and reduce the incidence of complications and mortality of patients and fetuses.Transfusion of blood products is an effective treatment to HELLP syndrome.
- severe preeclampsia /
- HELLP syndrome /
- risk factor /
- intensive critical unit

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参考文献(6)

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