HELLP综合征所致肝破裂的特点与治疗

Characteristics and treatment of hepatic rupture caused by HELLP syndrome.

作者信息

Araujo Ana C P F, Leao Marcos D, Nobrega Maria H, Bezerra Patricia F M, Pereira Flavio V M, Dantas Edailna M M, Azevedo George D, Jeronimo Selma M B

机构信息

Department of Gynecology and Obstetrics, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.

出版信息

Am J Obstet Gynecol. 2006 Jul;195(1):129-33. doi: 10.1016/j.ajog.2006.01.016. Epub 2006 Mar 30.

DOI:10.1016/j.ajog.2006.01.016

PMID:16579935

Abstract

OBJECTIVE

The purpose of this study was to review the management of hepatic rupture caused by HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome and to assess maternal and perinatal outcomes of these cases.

STUDY DESIGN

A retrospective study of HELLP syndrome cases that were complicated by hepatic rupture was conducted.

RESULTS

Ten cases of hepatic rupture were identified. The median maternal age was 42.5 +/- 5.9 years (median +/- SD), and the median gestational age at delivery was 35.5 +/- 4.9 weeks. The most frequent signs and symptoms of hepatic rupture were the sudden onset of abdominal pain, acute anemia, and hypotension. Laboratory findings included low platelet count and increased hepatic enzymes. Surgery was performed in 9 cases. One case was treated nonsurgically. The maternal mortality rate was 10%, and the perinatal mortality rate was 80%.

CONCLUSION

A combination of surgical treatment with hepatic artery ligation and omental patching with supportive measures was effective in decreasing the mortality rate in hepatic rupture caused by HELLP syndrome.

摘要

目的

本研究旨在回顾由HELLP（溶血、肝酶升高和血小板计数降低）综合征引起的肝破裂的治疗情况，并评估这些病例的孕产妇和围产期结局。

研究设计

对并发肝破裂的HELLP综合征病例进行回顾性研究。

结果

共识别出10例肝破裂病例。孕产妇年龄中位数为42.5±5.9岁（中位数±标准差），分娩时孕周中位数为35.5±4.9周。肝破裂最常见的体征和症状是突发腹痛、急性贫血和低血压。实验室检查结果包括血小板计数降低和肝酶升高。9例进行了手术治疗。1例采用非手术治疗。孕产妇死亡率为10%，围产期死亡率为80%。