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[HELLP综合征。102例分析]

[HELLP syndrome. Analysis of 102 cases].

作者信息

Helguera-Martínez A M, Tenorio-Marañón R, Vigil-de Gracia P E, García-Cáceres E

机构信息

Médicos Adscritos a la Unidad de Cuidados Intensivos Adultos del Hospital de Ginecoobstetricia No.4IMSS.

出版信息

Ginecol Obstet Mex. 1996 Dec;64:528-33.

PMID:9019434
Abstract

One hundred and two cases of HELLP Syndrome admitted at the Adults Intensive Care Unit since January 1992, to June 1994; 63 with severe preeclampsia, 26 eclamptics and 13 with chronic hypertension more preeclampsia-eclampsia were analysed. The mean age was 24 year (range, 15 to 42). All 102 of the patients had one or more symptoms, those more often were: headache (85), right upper-quadrant tenderness (61), nausea and/or vomiting (31). The diastolic blood pressure maximum before the admission was 100 mm Hg or less in patients and 46 had more than 110 mm Hg. The mean platelets count was 58000 (range, 17000 to 100000). The median of laboratory test were: lactic dehydrogenase (830 u/l), glutamic oxaloacetic transaminase (278 u/l), glutamic pyruvic transaminase (263 u/l), total bilirubin (3.3 mg/dl). There were complications in 37 patients; acute renal failure 20, disseminated intravascular coagulopathy in 11, cerebral hemorrhage in 10 and abruption placentae in 6 patients. During the study period there were 20 death due to preeclampsia-eclampsia and 14 were in patients with HELLP syndrome, cerebral hemorrhage was the main cause (70%). In the group study 11 intrauterine deaths were diagnosed.

摘要

自1992年1月至1994年6月,成人重症监护病房收治了102例HELLP综合征患者;其中63例为重度子痫前期,26例为子痫,13例为慢性高血压合并子痫前期-子痫,并对这些病例进行了分析。平均年龄为24岁(范围15至42岁)。所有102例患者均有一项或多项症状,最常见的症状为:头痛(85例)、右上腹压痛(61例)、恶心和/或呕吐(31例)。入院前患者舒张压最高值为100 mmHg或更低,46例患者舒张压超过110 mmHg。平均血小板计数为58000(范围17000至100000)。实验室检查中位数为:乳酸脱氢酶(830 u/l)、谷草转氨酶(278 u/l)、谷丙转氨酶(263 u/l)、总胆红素(3.3 mg/dl)。37例患者出现并发症;急性肾衰竭20例,弥散性血管内凝血11例,脑出血10例,胎盘早剥6例。研究期间,有20例患者死于子痫前期-子痫,其中14例为HELLP综合征患者,脑出血是主要死因(70%)。在研究组中,诊断出11例宫内死亡。

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