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运用早期血液透析、静脉注射免疫球蛋白及无创监测成功管理一名患有HELLP综合征、肺水肿、产后出血及急性肾衰竭的孕妇:一例报告

Successful management of a pregnant woman with HELLP syndrome, pulmonary edema, postpartum hemorrhage and acute renal failure, using early hemodialysis, intravenous immunoglobulin and noninvasive monitoring: a case report.

作者信息

Cho Fu-Nan, Chen San-Nung, Kan Yuen-Yee, Lee Te-Ching, Wang Jyh-Seng

机构信息

Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

出版信息

J Reprod Med. 2007 Jul;52(7):661-3.

Abstract

BACKGROUND

HELLP syndrome (hemolysis, elevated liver enzymes, low platelets) with medical complications is a major cause of maternal mortality in pregnancy. A vicious cycle may occur without expeditious delivery and proper management.

CASE

A woman with severe HELLP syndrome, hemolytic renal failure, pulmonary edema and postpartum hemorrhage was successfully managed using early hemodialysis, intravenous immunoglobulin (IVIG) and noninvasive hemodynamic monitoring.

CONCLUSION

Pulmonary edema is easily managed by early hemodialysis. IVIG may be a viable treatment for thrombocytopenia and hemolysis but can induce reversible interstitial nephritis and membranous glomerulonephritis.

摘要

背景

伴有医学并发症的HELLP综合征(溶血、肝酶升高、血小板减少)是妊娠产妇死亡的主要原因。若不迅速分娩和进行妥善处理,可能会出现恶性循环。

病例

一名患有严重HELLP综合征、溶血性肾衰竭、肺水肿和产后出血的女性,通过早期血液透析、静脉注射免疫球蛋白(IVIG)和无创血流动力学监测得到了成功治疗。

结论

早期血液透析可轻松处理肺水肿。IVIG可能是治疗血小板减少症和溶血的一种可行疗法,但可诱发可逆性间质性肾炎和膜性肾小球肾炎。

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