摘要
【摘要】目的探讨产后溶血性尿毒症综合征（postpartumhemolyticuremicsyndrome，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南京医科大学附属苏州医院2008年1月至2011年12月期间收治的6例PPHUS患者的临床资料进行分析。结果6例PPHUS患者均于剖宫产术后1d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、进行性血小板减少改变，经连续性静脉-静脉血液滤过、血浆置换、血液透析、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，1例治愈出院；5例好转出院，其中4例出院后随访3～6个月，肾功能均恢复正常，另一例治疗中自动出院，自行转院治疗，随访6个月，留有肾功能损害。结论PPHUS较罕见，属临床危急重症，早期诊断，及时正确治疗，有助于改善PPHUS患者预后。
Objective To explore the clinical manifestation, laboratory tests, diagnosis, treatment and prognosis of postpartum hemolytic uremic syndrome （PPHUS）. Methods Six cases of PPHUS diagnosed in the Affiliated Suzhou Hospital of Nanjing Medical University from January 2008 to December 2011 were retrospectively analyzed. Results After cesarean section 24 hours, 6 patients all had anuria, acute renal failure, microangiopathie hemolytic anemia and progressive thrombocytopenia. After a series of treatments, including blood purification, plasma exchange, hemodialysis, infusions of fresh frozen plasma, adrenal cortex hormones, anti-infection, anti-hypertensive and so on, 1 case recovered and 5 cases improved and discharged. In these 5 cases, 4 cases got renal function recovery during 3 - 6 months of follow-up and 1 case left hospital without cure, whose renal function was still abnormal after 6 months of follow-up. Conclusions PPHUS is rare and an emergency severe disease. Early diagnosis and correct treatment are helpful to improve the outcomes of PPHUS.
出处
《中华产科急救电子杂志》
2012年第2期38-42,共5页
Chinese Journal of Obstetric Emergency（Electronic Edition）
关键词
产后溶血性尿毒症综合征
早期诊断
早期治疗
血液净化
Postpartum hemolytic uremic syndrome
Early diagnosis
Early treatment
Hemofiltration
Plasmapheresis
