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目的 探讨与分析妊娠高血压综合征 (妊高征 )并发溶血、肝酶升高及血小板减少综合征(HELLP综合征 )临床表现、治疗及预后。方法 对妊高征并发HELLP综合征 2 6例患者的临床资料进行回顾性分析。结果 参照美国Mississippi分类和Tennessee分类修订诊断标准 ,HELLP综合征Ⅰ型 16例 ,HELLP综合征Ⅱ型 10例。对孕龄 <34周的Ⅱ型患者适当采取保守治疗 ,即严密监护母儿情况下积极治疗妊高征 ,早期使用糖皮质激素和抗血栓药物 ;对孕龄≥ 34周的Ⅰ、Ⅱ型患者及孕龄 <34周的I型患者 ,及时终止妊娠。终止妊娠前依病情使用血液制品以减少产后出血的发生率。 2 6例患者中死亡 1例 ,围生儿死亡 6例 ,病死率分别为 3.8%及 2 3.0 %。结论 HELLP综合征是重度妊高征的一种严重威胁母儿安全的并发症 ,及早发现并及时终止妊娠和应用糖皮质激素、抗血栓药物及血液制品可以降低母婴病死率
Objective To investigate and analyze the clinical manifestations, treatment and prognosis of pregnancy-induced hypertension (PIH) complicated by hemolysis, elevated liver enzymes and thrombocytopenic syndrome (HELLP syndrome). Methods The clinical data of 26 patients with PIH complicated with HELLP syndrome were retrospectively analyzed. Results According to the American Mississippi classification and Tennessee classification revised diagnostic criteria, HELLP syndrome type I 16 cases, HELLP syndrome type II 10 cases. For gestational age <34 weeks of Type Ⅱ patients appropriate conservative treatment, that is, intensive care of maternal and child cases of active treatment of pregnancy-induced hypertension, early use of glucocorticoid and antithrombotic drugs; gestational age ≥ 34 weeks of type Ⅰ, Ⅱ patients And gestational age <34 weeks of type I patients, timely termination of pregnancy. Premature pregnancy according to the condition of blood products to reduce the incidence of postpartum hemorrhage. There were 6 deaths in 6 patients, 6 perinatal deaths, and the mortality rates were 3.8% and 230% respectively. Conclusion HELLP syndrome is a serious risk of pregnancy-induced complications of pregnancy-induced hypertension, early detection and timely termination of pregnancy and application of glucocorticoid, antithrombotic drugs and blood products can reduce maternal and child mortality