血小板减少症合并HELLP综合征。两例血压正常且无蛋白尿孕妇病情逆转的报告。
Thrombocytopenia with the HELLP syndrome. Report of two cases with reversal in normotensive and nonproteinuric gravidas.
作者信息
Segal S, Shenhav S, Gemer O
机构信息
Department of Obstetrics and Gynecology, Barzilai Medical Center, Ashkelon, Israel.
出版信息
J Reprod Med. 1998 Mar;43(3):227-9.
BACKGROUND
In the absence of hypertension and proteinuria, pregnant women with hemolysis, elevated liver enzymes and low platelet count (HELLP syndrome) present a diagnostic and therapeutic problem.
CASES
Two atypical cases occurred of HELLP syndrome diagnosed by hemolysis, elevated liver enzymes and low platelet count. The patients presented early in the third trimester with epigastric pain and lacked the usual signs of preeclampsia, such as hypertension and proteinuria. The patients were managed expectantly; during this time they became hypertensive, but the thrombocytopenia resolved.
CONCLUSION
Pregnant women with hemolysis, elevated liver enzymes and thrombocytopenia who do not have hypertension or proteinuria should undergo complete diagnostic evaluation. If other etiologies are ruled out, the patient should be managed as appropriate for severe preeclampsia complicated by the HELLP syndrome.
背景
在无高血压和蛋白尿的情况下，患有溶血、肝酶升高和血小板计数降低（HELLP综合征）的孕妇存在诊断和治疗难题。
病例
出现了两例通过溶血、肝酶升高和血小板计数降低诊断出的HELLP综合征非典型病例。患者在孕晚期早期出现上腹部疼痛，且缺乏子痫前期的常见体征，如高血压和蛋白尿。对患者进行了期待治疗；在此期间她们出现了高血压，但血小板减少症得到缓解。
结论
患有溶血、肝酶升高和血小板减少症但无高血压或蛋白尿的孕妇应进行全面的诊断评估。如果排除了其他病因，应将患者作为重度子痫前期合并HELLP综合征进行适当处理。
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