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目的:探讨完全性HELLP综合征的血制品输注与孕产妇和胎儿/新生儿的围生结果。方法:回顾性分析完全性HELLP综合征病例资料,观察血制品输注保障下孕产妇产后出血等并发症发生情况和实验室指标变化情况,记录孕产妇及胎儿/新生儿围生结果。结果:完全性HELLP综合征发病率为0.15%,病例组孕产妇平均孕周为(33.3±7.0)周,其中33.3%并发急性肾功衰,33.3%并发弥漫性血管内凝血,产后出血率50.0%,病死率17.0%;胎儿病死率28.5%,早产儿占14.3%,新生儿窒息率为40.0%。6例孕产妇共输注单采血小板14治疗量、少白红细胞悬液62U、冰冻血浆2100ml、冷沉淀40U,其中治疗前PLT为(27.0±8.9)×109/L,冶疗后为(141.0±41.4)×109/L。结论:完全性HELLP综合征仍是严重威胁孕产妇和胎儿/新生儿生命安全的恶性并发症,单采血小板等血制品输注是治疗HELLP综合征的安全保障。
Objective: To investigate the perinatal outcome of transfusion of blood products and maternal and fetal / newborn infants with complete HELLP syndrome. Methods: The data of complete HELLP syndrome were retrospectively analyzed. The incidence of complications such as postpartum hemorrhage and the changes of laboratory indexes under the protection of blood products infusion were observed. The perinatal outcome of pregnant women and fetuses / newborns was recorded. Results: The incidence of complete HELLP syndrome was 0.15%. The mean gestational age of pregnant women in the case group was (33.3 ± 7.0) weeks. 33.3% of them were complicated with acute renal failure, 33.3% complicated with diffuse intravascular coagulation, and the postpartum hemorrhage rate was 50.0 %, The case fatality rate was 17.0%; the fetal fatality rate was 28.5%; the premature infant accounted for 14.3%; the neonatal asphyxia rate was 40.0%. Six pregnant women received single-platelet transfusion of 14 doses of treatment, white blood cells suspension 62U, frozen plasma 2100ml, cryoprecipitate 40U, PLT was (27.0 ± 8.9) × 109 / L before treatment, after treatment was (141.0 ± 41.4) × 109 / L. Conclusion: Complete HELLP syndrome remains a serious complication of life-threatening maternal and fetal / neonatal complications. Infusion of blood products such as apheresis plateau is a safeguards for the treatment of HELLP syndrome.