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并发肝血肿的HELLP综合征的诊断与管理

Diagnosis and Management of HELLP Syndrome Complicated by Liver Hematoma.

作者信息

Ditisheim Agnès, Sibai Baha M

机构信息

*Department of Obstetrics and Gynecology, McGovern Medical School at UTHealth, Houston, Texas †Faculty of Medicine, University of Geneva, Switzerland.

出版信息

Clin Obstet Gynecol. 2017 Mar;60(1):190-197. doi: 10.1097/GRF.0000000000000253.

Abstract

Subcapsular liver hematoma is a rare but potentially life-threatening complication of preeclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome. It may present with nonspecific signs and symptoms, none of which are diagnostic, and can mimic pulmonary embolism of cholecystitis. There is no consensus on the management of subcapsular liver hematoma. Unruptured liver hematoma can be conservatively managed. When rupture occurs, surgical, endovascular approaches and, rarely, liver transplantation, may be required. Actual literature is scant and retrospective in nature. Data on follow-up, time to resolution and outcome of subsequent pregnancies are very limited. We here review the diagnosis and management of liver hematoma.

摘要

肝包膜下血肿是先兆子痫和溶血、肝酶升高及血小板减少综合征(HELLP综合征)一种罕见但可能危及生命的并发症。它可能表现为非特异性的体征和症状,没有一项具有诊断性,且可类似胆囊炎或肺栓塞。对于肝包膜下血肿的处理尚无共识。未破裂的肝血肿可采用保守治疗。当发生破裂时,可能需要手术、血管内治疗,很少情况下需要肝移植。实际的文献资料很少且多为回顾性研究。关于随访、血肿消退时间及后续妊娠结局的数据非常有限。我们在此对肝血肿的诊断和处理进行综述。

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