El Youssoufi S, Nsiri A, Salmi S, Miguil M
Service d'Anesthésie-Réanimation Obstétricale, CHU Ibn-Rochd, Casablanca, Maroc.
J Gynecol Obstet Biol Reprod (Paris). 2007 Feb;36(1):57-61. doi: 10.1016/j.jgyn.2006.09.003. Epub 2007 Jan 8.
Subcapsular liver hematoma (SLH) is a serious complication of the preeclampsia and HELLP syndrom. We report eight cases, and we'll precise circumstances of occurrence of this complication, its management and its prognosis.
Between January 2000 and December 2005, we enrolled eight patients with SLH cases in the intensive care unit of maternity's Ibn Rochd university hospital in Casablanca, Morocco.
The patients are 22 to 41-years-old; six are multiparous, without prenatal care. All are preeclamptic. We diagnosed the SLH in prepartum stage in one case, in operating room in five cases and in post partum stage in two cases. We established blood pressure and homeostasis disturbances, the surgeon made packing for six patients with hepatic artery ligature in two cases. In two other patients, we did only medical care. We noted five deaths, four after hematoma rupture.
These results were compared with literature, we need to look for this complication in all-severe preeclampsia with HELLP syndrome, and treat all haemostatic disorders.
肝包膜下血肿(SLH)是子痫前期和HELLP综合征的严重并发症。我们报告8例病例,并详述该并发症的发生情况、处理方法及预后。
2000年1月至2005年12月期间,我们将摩洛哥卡萨布兰卡伊本·罗什德大学医院妇产科重症监护病房收治的8例肝包膜下血肿患者纳入研究。
患者年龄在22至41岁之间;6例为经产妇,未接受产前检查。所有患者均患有子痫前期。1例在产前阶段诊断出肝包膜下血肿,5例在手术室诊断出,2例在产后阶段诊断出。我们发现了血压和内稳态紊乱,外科医生对6例患者进行了填塞,其中2例进行了肝动脉结扎。另外2例患者仅接受了药物治疗。我们记录到5例死亡,4例死于血肿破裂。
将这些结果与文献进行比较后发现,我们需要在所有重度子痫前期合并HELLP综合征的病例中寻找该并发症,并治疗所有止血障碍。