抢救1例HELLP综合征并发肝包膜下血肿、破裂出血休克的报道

Abstract
Figure/Table
References (16)
Related Citation (9)

Download: PDF (0 KB) HTML (37 KB)
Export: BibTeX | EndNote (RIS)

Abstract HELLP syndrome is one of the serious complications of severe preeclampsia，complicated with hepatic capsular rupture and hemorrhage，which is a rare critical and severe obstetric disease. The disease changes rapidly and dangerously，which seriously threatens the health of mother and child. Its complex clinical manifestation poses a great challenge for clinical thinking and rapid response ability of clinicians. At present，clinicians have insufficient understanding of this disease，lack of clinical experience，especially in timely treatment and drug selection. However，comprehensive assessment of maternal condition，etiology identification，early diagnosis，timely treatment and multidisciplinary treatment are the keys to reducing the morbidity and mortality of gravida and fetus. This article reports a case of a successful multidisciplinary rescue of a pregnant woman with HELLP syndrome complicated with hepatic rupture and hemorrhagic shock. After admission，this pregnant woman underwent emergency ultrasound examination，quickly started green channel and hepatobiliary surgery to perform cesarean section，together with hepatic artery ligation，hepatic wound compression，hemostasis and ICU rescue after operation. After more than 2 months of multidisciplinary treatment，the patient recovered and was discharged from hospital. Through the comprehensive analysis of the symptoms，physical examination，clinical examination results，medical history，diagnosis and treatment process of the pregnant woman，the purpose is to summarize the treatment experience and lessons，so as to improve the rapid response ability of the obstetrics team，rapid and accurate assessment of disease changes and comprehensive treatment level.

Key words： HELLP syndrome Hepatic capsular rupture and hemorrhage Rapid response Multidisciplinary cooperation

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	HUANG Chun-yan
	CHENG Qiu-rong
	ZHOU Shuang

Cite this article:

HUANG Chun-yan,CHENG Qiu-rong,ZHOU Shuang. Rescuing a pregnant woman with HELLP syndrome complicated with hepatic subcapsular hematoma and rupture hemorrhagic shock: a case report[J]. 中国当代医药, 2020, 27(18): 209-212.

URL:

http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2020/V27/I18/209

［1］	Curtin WM，Weinstein L.A review of HELLP syndrome［J］.J Perinatol，1999，19（2）：138-143.
［2］	Lam MTC，Dierking E.Intensive Care Unit issues in eclampsia and HELLP syndrome［J］.Int J Crit Illn Inj Sci，2017，7（3）：136-141.
［3］	吴金珊，李雅男.子痛并发HELLP 综合片20 例患者的临床特点及母婴结局［J］.中国实用医药，2019，14（32）：3-5.
［4］	中国医师协会急诊医师分会，中国高血压联盟，北京高血压防治协会. 中国急诊高血压诊疗专家共识（2017 修订版）［J］.中国实用内科杂志，2018，38（5）：421-433.
［5］	苟文丽，薛艳.妊娠期高血压疾病国际指南与中国实践［J］.中国实用妇科与产科杂志，2017，33（6）：559-563.
［6］	杨宁，李玉明.从指南变迁看妊娠期高血压疾病的诊治［J］.中国实用内科杂志，2019，39（1）：23-26.
［7］	伊海英，李银凤.HELLP 综合片的研究进展［J］.世界最新医学信息文献，2017，17（86）：40-42.
［8］	周琼，曾万江.妊娠期溶血的管理［J］.中华产科急救电子杂志，2018，7（2）：108-112.
［9］	杨怡珂，漆洪波.美国妇产科医师学会（ACOG）“妊娠期高血压和子痛前期指南2019 版”要点解读（第一部分）［J］.中国实用妇科与产科杂志，2019，35（8）：895-899.
［10］	Shenhav S，Gemer OM，Zohav E，et al.Midtrimester triple test levels in women with severe preeclampsia and HELLP syndrome［J］.Acta Obstet Gynecol Scand，2003，82（10）：912-915.
［11］	陈志英，陈洁.妊娠期糖尿病并发子痛前期的危险因素及妊娠结局分析［J］.中国妇幼保健，2017，32（12）：2616-2618.
［12］	任丹玉，王永红.凝血功能指标和血小板参数对子痛前期及其严重程度的辅助诊断价值研究［J］.中国全科医学，2019，22（22）：2698-2704.
［13］	仲子星，杨立伟.HELLP 综合片1 例报道并文献复习［J］.上海预防医学，2017，29（1）：81，86.
［14］	Troja A，Abdou A，Rapp C，et al.Management of spontaneous hepatic rupture on top of HELLP syndrome：case report and review of the literature［J］.Viszeralmedizin，2015，31（3）：205-208.
［15］	Lamireau D，Feghali H，Redonnet-Vernhet I，et al.Acute fatty liver in pregnancy：revealing fetal fatty acid oxidation disorders［J］.Arch Pediatr，2012，19（3）：277-281.
［16］	Sandvo BM，Potthast AB，Versen-Hoynck VF，et al.HELLP syndrome：altered hypoxic response of the fatty acid oxidation regulator SIRT 4［J］.Reprod Sci，2017，24（4）：568-574.