Rathgeber J, Rath W, Wieding J U
Zentrum Anaesthesiologie, Georg-August-Universität Göttingen.
Anasth Intensivther Notfallmed. 1990 Jun;25(3):206-11.
From 1984 to 1988 22 patients with preeclampsia and HELLP syndrome were treated in our ICU. The HELLP syndrome is defined as preeclampsia complicated by thrombocytopenia, hemolysis and disturbed liver function. 3 patients developed a severe DIC with consumption of hemostatic potential. One patient died in multiorgan failure having a consumption coagulopathy, liver rupture and renal failure. To prevent severe hemostatic complications, it is essential to start therapy of DIC as soon as possible by inhibition of the activated coagulation system. Bleeding caused by blood coagulation disorders can occur spontaneously and during operative treatment. Epidural or spinal anaesthesia should be avoided in patients with HELLP syndrome. Because of severe complications such as respiratory failure, diffuse bleeding caused by DIC and progressive deterioration of the renal and liver function in most of the cases, patients with HELLP syndrome require a close cooperation between obstetrics and anesthesist.
1984年至1988年期间，我们的重症监护病房（ICU）收治了22例先兆子痫合并HELLP综合征的患者。HELLP综合征的定义为子痫前期合并血小板减少、溶血及肝功能紊乱。3例患者发生严重弥散性血管内凝血（DIC），止血潜能消耗。1例患者死于多器官功能衰竭，存在消耗性凝血病、肝破裂及肾衰竭。为预防严重的止血并发症，必须通过抑制激活的凝血系统尽快开始DIC治疗。凝血障碍导致的出血可自发发生，也可在手术治疗期间出现。HELLP综合征患者应避免硬膜外或脊髓麻醉。由于大多数病例存在诸如呼吸衰竭、DIC导致的弥漫性出血以及肾功能和肝功能进行性恶化等严重并发症，HELLP综合征患者需要产科医生和麻醉医生密切合作。
