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一名患有肝破裂并伴有HELLP综合征的孕妇的多学科管理。

Multidisciplinary management of a pregnant woman with hepatic rupture complicated with HELLP syndrome.

作者信息

Ren Jing, Chen Hui, Dong Yan, Sun Qiang, Liu Tao, Dong Fang, Qiao Yuangang

机构信息

Department of Obstetrics, Affiliated Hospital of Jining Medicine University Jining 272000, Shandong, China.

Department of Critical Care Medicine, Affiliated Hospital of Jining Medicine University Jining 272000, Shandong, China.

出版信息

Am J Transl Res. 2024 Mar 15;16(3):933-939. doi: 10.62347/RASL4490. eCollection 2024.

Abstract

A 32-year-old woman with preeclampsia who presented with persistent severe hypertension and epigastric pain underwent an emergency cesarean section for fetal distress and was diagnosed with hepatic rupture and HELLP (hemolysis, elevated liver enzymes, and a low platelet) syndrome. After the operation, the patient was transferred to the intensive care unit for supportive treatment and management of complications. Diagnosis and treatment decisions were made through multidisciplinary management. The patient received plasma exchange and continuous renal replacement therapy. One week after the operation, the patient developed deep vein thrombosis and received anticoagulant therapy, which triggered rebleeding. Conservative treatment was taken, including halving the dosage of anticoagulant medication and performing a blood transfusion, and the patient's condition gradually stabilized. The patient was discharged 44 days after the operation. Early diagnosis, effective treatment, and multidisciplinary management can help patients with this critical presentation achieve good clinical outcomes.

摘要

一名32岁的子痫前期女性,出现持续性严重高血压和上腹部疼痛,因胎儿窘迫接受了急诊剖宫产,被诊断为肝破裂和HELLP(溶血、肝酶升高和血小板减少)综合征。术后,患者被转入重症监护病房进行支持治疗和并发症管理。通过多学科管理做出诊断和治疗决策。患者接受了血浆置换和连续性肾脏替代治疗。术后一周,患者发生深静脉血栓并接受抗凝治疗,这引发了再次出血。采取了保守治疗,包括将抗凝药物剂量减半并进行输血,患者的病情逐渐稳定。患者术后44天出院。早期诊断、有效治疗和多学科管理有助于患有这种危急病症的患者取得良好的临床结局。

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Therapeutic plasma exchange in HELLP syndrome: A life savior.HELLP综合征中的治疗性血浆置换:救命稻草。
Asian J Transfus Sci. 2022 Jan-Jun;16(1):106-110. doi: 10.4103/ajts.ajts_176_20. Epub 2022 May 26.
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Postpartum HELLP syndrome complicated with large subcapsular liver hematoma.产后HELLP综合征合并巨大肝包膜下血肿。
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