摘要
目的:分析单采血小板输注治疗I型HELLP综合征的母婴结局,探讨单采血小板在I型HELLP综合征治疗中的应用价值。方法:Ⅰ型HELLP综合征病例,观察单采血小板输注下血小板指标变化情况,记录孕产妇并发症及围生儿结局。结果:Ⅰ型HELLP综合征发病率为0.15%,病例组孕产妇平均孕周33周,其中66.6%合并重度子痫前期,33.3%合并急性肾功衰,33.3%合并弥散性血管内凝血,16.7%合并胎盘早剥,产后出血率为50.0%,死亡率17.0%;胎儿死亡率28.5%,早产儿占14.3%,新生儿窒息发生率为40.0%。6例孕产妇共输注单采血小板14治疗量,其中治疗前PLT为(27.0±8.9)×109/L,治疗后为(141.0±41.4)×109/L。结论:Ⅰ型HELLP综合征严重威胁母婴生命安全,单采血小板输注是治疗I型HELLP综合征的安全保障。
Objective： To analyze the outcomes of mother and fetus when apheresis platelet transfusion was used in the treatment of class I HELLP syndrome, and explore the application value of the therapeutic apheresis platelet infusion in the treatment of class I HELLP syndrome. Methods： A retrospective analysis was done of the patients with class I HELLP syndrome from January 2009 to December 2011. The changes of platelet counts （ PLT）, maternal complications and perinatal children outcome were observed. Results ： The incidence of class I HELLP syndrome was 0. 15%. The average pregnant weeks of the patients was 33 weeks. There were 66. 6% pregnant women com- plicated with severe preeclampsia, 33.3% of patients with acute renal failure, 33.3% of patients with diffuse intravascular coagulation, 16. 7% of patients with placental abruption. The incidence of postpartum hemorrhage was 50%. The mortality rate was 17% for mother and 28.5% for fetal. Premature delivery accounted for 14. 3%. The incidence of neonatal asphyxia was 40%. The six patients received 14 thera- peutic dosages of apheresis platelets. The PLT before and after treatment were （27.0 ± 8.9） × 109/L and （ 141.0 ± 41.4） × 109/L, re- spectively. Conclusion： Class I HELLP syndrome is a serious life threatening syndrome for both mother and fetus. Apheresis platelet trans- fusion is the security for the treatment of class I HELLP syndrome.
出处
《中国妇幼保健》
CAS
北大核心
2013年第14期2202-2204,共3页
Maternal and Child Health Care of China
关键词
HELLP综合征
妊娠结局
血小板减少
输血
HELLP syndrome
Outcomes of pregnancy
Thrombocytopenia
Blood transfusion
