论文部分内容阅读
目的探讨产后溶血性尿毒症综合征(Postpartum hemolytic uremiu syndrome,PPHUS)的临床表现、实验室检查、诊断、治疗及预后。方法采用回顾性研究方法对9例PPHUS患者的临床资料进行分析。结果 9例PPHUS患者均于产后1天左右出现无尿和急性肾功能衰竭,实验室检查呈微血管病性溶血性贫血、进行性血小板减少,经透析治疗、输注冰冻血浆、肾上腺皮质激素、抗感染以及降压等综合治疗,9例PPHUS患者中,1例治愈出院,8例好转出院,其中7例出院后随访3~6月肾功能均恢复正常,另一例治疗1个月后自动出院,自行转院治疗,随访6个月,留有肾功能损害,尿量正常,血肌酐在200 ummol/L左右,为氮质血症期。无产妇死亡。该病病程较长,产后住院时间最短22天,最长56天,属临床危急重症。结论论早期诊断,及时正确治疗,有助于改善PPHUS患者预后。
Objective To investigate the clinical manifestations, laboratory tests, diagnosis, treatment and prognosis of postpartum hemolytic uremic syndrome (PPHUS). Methods The clinical data of 9 patients with PPHUS were analyzed retrospectively. Results All 9 patients with PPHUS presented with anuria and acute renal failure about 1 day after delivery. The laboratory tests showed microangiopathic hemolytic anemia, progressive thrombocytopenia, dialysis treatment, infusion of frozen plasma, adrenocorticotropic hormone, Infection and antihypertensive treatment. Among 9 PPHUS patients, 1 was cured and 8 patients were discharged. Among them, 7 patients were followed up for 3 to 6 months and their renal function returned to normal. The other patients were discharged after 1 month, Self-transfer of treatment, followed up for 6 months, leaving renal dysfunction, normal urine output, serum creatinine in about 200 ummol / L, azotemia. No maternal deaths. The longer duration of the disease, postpartum hospitalization for a minimum of 22 days, up to 56 days, is a clinical critically ill. Conclusions On the early diagnosis, timely and correct treatment, will help improve the prognosis of patients with PPHUS.