[HELLP综合征的当前管理]。

C Bartz, W Rath
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引用次数: 5

摘要

HELLP综合征作为微血管病变综合征的一部分,由于其可能迅速的临床恶化,需要特别注意快速准确的诊断和鉴别诊断。它的定义是溶血、肝酶升高和血小板计数低的经典三联征,这可能导致与预后相关的问题,难以与血栓性血小板减少性紫癜和溶血性尿毒症综合征以及其他与妊娠相关和无关的肝脏疾病区分,即主要与其他肝脏疾病相似,如急性脂肪肝或妊娠肝内胆汁淤积或与妊娠无关的情况,如病毒性肝炎。在怀孕的不同阶段的管理详细描述。讨论了延长妊娠的治疗方案,以及后续妊娠预防的可能性和随访的各个方面。
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[Current management of the HELLP syndrome].

The HELLP syndrome as part of the microangiopathic syndromes requires special attention in terms of a rapid and accurate diagnostic and differential diagnostic workup because of its possibly rapid clinical deterioration. It is defined by the classical triad of hemolysis,elevated liver enzymes and low platelet counts which may lead to prognostically relevant problems in differentiating it from thrombotic-thrombocytopenic purpura and hemolytic-uremic syndrome and other pregnancy-related and unrelated liver diseases, i.e. mainly clinical and laboratory similarities to other liver diseases such as acute fatty liver or intrahepatic cholestasis in pregnancy or pregnancy-unrelated settings like viral hepatitides. The management in the different phases of pregnancy is described in detail. Therapeutic options to prolong pregnancy are discussed as are the possibilities of prophylaxis in subsequent pregnancies and aspects of the followup.

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