Kojima Nana, Kuroda Kosuke, Tani Makiko, Kanazawa Tomoyuki, Shimizu Kazuyoshi, Maki Jota, Masuyama Hisashi, Morimatsu Hiroshi
Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.
Department of Anesthesiology, Kochi Health Sciences Center, Kochi, Japan.
JA Clin Rep. 2023 Feb 20;9(1):9. doi: 10.1186/s40981-023-00602-2.
Postpartum hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome is more difficult to treat than HELLP syndrome during pregnancy. We describe a case of postpartum HELLP syndrome that responded to plasma exchange (PE) therapy.
A 30-year-old primipara woman was hospitalized for gestational hypertension at 33 weeks of gestation and underwent an emergent cesarean section at 36 weeks and 6 days of gestation due to rapidly progressing pulmonary edema. After delivery, liver dysfunction and a rapid decrease in platelet count were observed, and the patient was diagnosed with severe HELLP syndrome. She experienced multiple organ failure despite intensive care, and PE therapy was initiated. Her general condition dramatically stabilized within a few hours of PE therapy.
It is controversial whether PE therapy should be used primarily in the management of HELLP syndrome, but early initiation of PE therapy could be effective for severe HELLP syndrome.
产后溶血、肝酶升高及血小板减少（HELLP）综合征比孕期HELLP综合征更难治疗。我们描述了一例对血浆置换（PE）治疗有反应的产后HELLP综合征病例。
一名30岁初产妇在妊娠33周因妊娠高血压住院，在妊娠36周6天时因迅速进展的肺水肿接受急诊剖宫产。产后，观察到肝功能障碍和血小板计数迅速下降，患者被诊断为重度HELLP综合征。尽管进行了重症监护，她仍出现多器官功能衰竭，并开始进行PE治疗。在PE治疗后几小时内，她的一般状况显著稳定。
PE治疗是否应主要用于HELLP综合征的管理存在争议，但早期开始PE治疗可能对重度HELLP综合征有效。
