Ulrich S, Piper C, Kalder M, Berle P
Frauenklinik, Dr.-Horst-Schmidt-Kliniken, Wiesbaden.
Geburtshilfe Frauenheilkd. 1996 Aug;56(8):443-6. doi: 10.1055/s-2007-1023263.
This report is on a severe case fo a HELLP-syndrome (H haemolysis, EL elevated liver enzymes, and LP low platelets). A 32-year old gravida developed severe preeclampsia with epigastric pain at 33 weeks' gestation. During a few hours post partum she showed disseminated intravascular coagulation (DIC) and required intensive care. The severe HELLP-syndrome was combined with a fast increasing acute respiratory distress syndrome (ARDS) and acute oligo-anuric renal failure. She was treated in the intensive-care unit for several days with artificial respiration, 10 acute haemodialyses, 4 plasma exchanges with fresh-frozen plasma and many blood and platelet transfusions. An early Caesarean section and treatment in the intensive care unit managed to turn the otherwise complicated progression of the disease. It is pointed out that plasma exchange with fresh-frozen plasma is a rarely employed treatment.
本报告讲述了一例严重的HELLP综合征(H代表溶血,EL代表肝酶升高,LP代表血小板减少)病例。一名32岁孕妇在妊娠33周时出现重度子痫前期并伴有上腹部疼痛。产后数小时内,她出现了弥散性血管内凝血(DIC),需要重症监护。严重的HELLP综合征合并了迅速进展的急性呼吸窘迫综合征(ARDS)和急性少尿性肾衰竭。她在重症监护病房接受了数天治疗,包括人工呼吸、10次急性血液透析、4次用新鲜冷冻血浆进行的血浆置换以及多次输血和血小板输注。早期剖宫产及在重症监护病房的治疗成功扭转了原本复杂的疾病进展。文中指出,用新鲜冷冻血浆进行血浆置换是一种很少采用的治疗方法。