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目的:探讨重症医学科收治的重度子痫前期(SPE)并发HELLP综合征患者的危险因素、临床特征、预后和临床治疗分析,以期改善母婴预后。方法:回顾性分析我院2007-01-2016-12ICU收治的SPE患者125例,根据有无并发HELLP综合征分为HELLP组和非HELLP组,使用卡方检验和方差分析比较2组患者的一般资料、临床特征、治疗措施、预后等临床资料。结果:125例SPE孕产妇中,并发HELLP综合征者26例,发生率为20.8%。经产妇、高龄及非规律产前检查易合并发生HELLP。2组间输血率、天冬氨酸转氨酶、丙氨酸转氨酶、总胆红素、肌苷、血糖、D-二聚体、血小板计数、新生儿Apgar评分(1、5、10min)、ICU住院天数及成分输血比较差异均有统计学意义(P<0.05)。2组均无孕妇发生死亡,新生儿存活率比较差异无统计学意义。结论:本研究中,SPE并发HELLP综合征患者中,经产妇、高龄、非规律产检是危险因素;孕期动态监测子痫前期患者外周血小板计数、D-二聚体、肝肾功能等指标,对预防和早期发现HELLP综合征,降低母婴并发症及病死率有一定的价值。成分输血是治疗HELLP综合征的有效手段。
Objective: To investigate the risk factors, clinical characteristics, prognosis and clinical treatment of severe preeclampsia (SPE) complicated with HELLP syndrome admitted to the Department of Critical Care Medicine to improve the prognosis of maternal and infant. Methods: A retrospective analysis of 125 cases of SPE patients admitted to our hospital from January 2007 to December 2016 in ICU was divided into HELLP group and non-HELLP group according to the presence or absence of HELLP syndrome. Chi-square test and ANOVA were used to compare the two groups Data, clinical features, treatment measures, prognosis and other clinical data. Results: In 125 cases of pregnant women with SPE, HELLP syndrome in 26 cases, the incidence was 20.8%. Through the maternal, elderly and irregular prenatal examination prone to HELLP. Blood transfusion rates, aspartate aminotransferase, alanine aminotransferase, total bilirubin, inosine, blood glucose, D-dimer, platelet count, Neonatal Apgar score (1,5,10 min) There were significant differences in days and components of blood transfusion (P <0.05). No death occurred in both groups, the survival rate of newborns was no significant difference. Conclusions: In this study, among the patients with SPE complicated with HELLP syndrome, the maternal, elderly and non-regular maternity tests were risk factors. Peripheral blood platelet counts, D-dimer and liver and kidney function were dynamically monitored during pregnancy Prevention and early detection of HELLP syndrome, reduce maternal and child complications and mortality has a certain value. Component transfusion is an effective treatment for HELLP syndrome.