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目的探讨子痫并HELLP综合征患者的临床特征、诊断及治疗方法、母婴结局。方法回顾性分析12例子痫并HELLP综合征患者的临床资料。结果 12例均有抽搐、不同程度的血压增高,下肢水肿11例,头晕、头痛8例,视物模糊3例,恶心、呕吐5例,右上腹疼痛2例,浑身乏力1例,入院时神志不清1例;实验室检查示12例均有不同程度肝、肾功能损害;11例行头颅CT检查,9例存在不同程度对称性脑实质缺血灶,伴脑积水、脑实质出血、脑实质多发梗死灶各1例;产前子痫并HELLP综合征5例,产后子痫并HELLP综合征7例;完全性HELLP综合征8例,部分性HELLP综合征4例;12例均接受肾上腺糖皮质激素冲击及血浆置换治疗,3例输注浓缩红细胞,2例输注血小板;11例行剖宫产术,1例家中经阴道分娩;围产儿死亡4例,孕产妇死亡1例。结论子痫并HELLP病情危重,密切关注其临床表现,对症处理和及时终止妊娠,可改善母婴预后。
Objective To investigate the clinical features, diagnosis and treatment of eclampsia with HELLP syndrome and maternal and infant outcomes. Methods The clinical data of 12 patients with eclampsia and HELLP syndrome were retrospectively analyzed. Results All of the 12 patients had convulsions, varying degrees of blood pressure, 11 cases of edema of the lower extremities, 8 cases of dizziness and headache, 3 cases of blurred vision, 5 cases of nausea and vomiting, 2 cases of right upper quadrant pain and 1 case of weakness. 1 case was unclear; laboratory tests showed that all 12 cases had liver and kidney dysfunction; 11 cases had cranial CT examination, 9 cases had symmetrical cerebral parenchymal ischemic foci with hydrocephalus, cerebral parenchymal hemorrhage, Brain parenchyma infarction in 1 case; prenatal eclampsia and HELLP syndrome in 5 cases, postpartum eclampsia and HELLP syndrome in 7 cases; complete HELLP syndrome in 8 cases, partial HELLP syndrome in 4 cases; 12 cases were accepted Adrenal glucocorticoid shock and plasma exchange therapy, 3 cases of infusion of concentrated red blood cells, 2 cases of platelet transfusion; 11 cases of cesarean section, 1 case of vaginal delivery at home; perinatal death in 4 cases, 1 maternal death. Conclusions The condition of eclampsia and HELLP is critically ill, pay close attention to its clinical manifestations, symptomatic treatment and timely termination of pregnancy, can improve maternal and infant prognosis.