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HELLP 综合征致剖宫产术后巨大肝包膜下血肿合并肝梗死的保守治疗：1 例报告并文献复习。

Conservative Treatment of Huge Hepatic Subcapsular Hematoma Complicated with Hepatic Infarction after Cesarean Section Caused by HELLP Syndrome - a Case Report and Literature Review.

机构信息

Department of Obstetrics, Pingxiang Maternal and Child Health Hospital, Pingxiang, China.

Department of Gynecology, Clinical Oncology School of Fujian Medical University,Fujian Cancer Hospital, Fuzhou, China.

出版信息

Z Geburtshilfe Neonatol. 2023 Jun;227(3):219-226. doi: 10.1055/a-1967-2451. Epub 2023 Feb 27.

DOI:10.1055/a-1967-2451
PMID:36849111
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10243897/
Abstract

Hepatic subcapsular hematoma and hepatic infarction in labor are mostly secondary to HELLP syndrome and preeclampsia. There are few reported cases with a complicated diagnosis and treatment and high mortality. Here, we present a case of a huge hepatic subcapsular hematoma complicated with hepatic infarction after cesarean section that was secondary to HELLP syndrome and the patient was treated conservatively. Further, we have discussed the diagnosis and treatment of hepatic subcapsular hematoma and hepatic infarction caused by HELLP syndrome.

摘要

肝包膜下血肿和分娩时肝梗死主要继发于 HELLP 综合征和子痫前期。报道的病例很少，诊断和治疗复杂，死亡率高。本文报道了 1 例因 HELLP 综合征行剖宫产术后并发巨大肝包膜下血肿合并肝梗死的病例，该患者接受了保守治疗。进一步探讨了 HELLP 综合征引起的肝包膜下血肿和肝梗死的诊断和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9984/10243897/c55202db89c9/10-1055-a-1967-2451-i03-2022-0576-0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9984/10243897/b651065d84d5/10-1055-a-1967-2451-i03-2022-0576-0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9984/10243897/a9108c1e35ce/10-1055-a-1967-2451-i03-2022-0576-0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9984/10243897/c55202db89c9/10-1055-a-1967-2451-i03-2022-0576-0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9984/10243897/b651065d84d5/10-1055-a-1967-2451-i03-2022-0576-0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9984/10243897/a9108c1e35ce/10-1055-a-1967-2451-i03-2022-0576-0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9984/10243897/c55202db89c9/10-1055-a-1967-2451-i03-2022-0576-0003.jpg

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本文引用的文献

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The effect of therapeutic plasma exchange on management of HELLP Syndrome: The report of 47 patients.治疗性血浆置换对 HELLP 综合征治疗的影响：47 例患者报告。
Transfus Apher Sci. 2021 Oct;60(5):103248. doi: 10.1016/j.transci.2021.103248. Epub 2021 Aug 14.
2
Managing a rare complication of HELLP syndrome in Australia: Spontaneous liver haematoma in pregnancy.管理澳大利亚 HELLP 综合征的罕见并发症：妊娠自发性肝血肿。
Aust N Z J Obstet Gynaecol. 2021 Apr;61(2):188-194. doi: 10.1111/ajo.13318. Epub 2021 Feb 12.
3
Acute liver failure and HELLP syndrome: A clinical case and literature review.
当救命措施导致创伤时：心肺复苏术后肝包膜下血肿
Radiol Case Rep. 2024 Oct 30;20(1):379-383. doi: 10.1016/j.radcr.2024.10.006. eCollection 2025 Jan.
4
Spontaneously ruptured huge hepatic subcapsular hematoma associated with preeclampsia: A case report and literature review.自发性破裂巨大肝包膜下血肿合并子痫前期 1 例报告并文献复习
J Int Med Res. 2024 Jul;52(7):3000605241264220. doi: 10.1177/03000605241264220.
急性肝衰竭与HELLP综合征：一例临床病例及文献综述
Clin Res Hepatol Gastroenterol. 2021 Mar;45(2):101498. doi: 10.1016/j.clinre.2020.07.005. Epub 2020 Aug 20.
4
Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin Summary, Number 222.妊娠期高血压与子痫前期：ACOG 实践通报摘要，第 222 号。
Obstet Gynecol. 2020 Jun;135(6):1492-1495. doi: 10.1097/AOG.0000000000003892.
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The role of hepatic sinusoidal obstruction in the pathogenesis of the hepatic involvement in HELLP syndrome: Exploring the literature.探讨文献：肝脏窦状隙阻塞在 HELLP 综合征肝脏受累发病机制中的作用。
Pregnancy Hypertens. 2020 Jan;19:37-43. doi: 10.1016/j.preghy.2019.11.012. Epub 2019 Dec 23.
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BMC Pregnancy Childbirth. 2018 May 30;18(1):191. doi: 10.1186/s12884-018-1799-9.
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The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice.妊娠期高血压疾病：国际妊娠高血压研究学会（ISSHP）国际实践分类、诊断及管理建议
Pregnancy Hypertens. 2018 Jul;13:291-310. doi: 10.1016/j.preghy.2018.05.004. Epub 2018 May 24.
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