切换至 "中华医学电子期刊资源库"

中华产科急救电子杂志 ›› 2018, Vol. 07 ›› Issue (01) : 58 -61. doi: 10.3877/cma.j.issn.2095-3259.2018.01.013

所属专题: 经典病例 经典病例 文献

病例报告

HELLP综合征并发脑出血一例
黄林杰1, 郭娟娟1, 张元珍1,()   
  1. 1. 430071 湖北,武汉大学中南医院妇产科
  • 收稿日期:2017-11-15 出版日期:2018-02-18
  • 通信作者: 张元珍

A case report of HELLP syndrome complicated with cerebral hemorrhage

Linjie Huang1, Juanjuan Guo1, Yuanzhen Zhang1()   

  • Received:2017-11-15 Published:2018-02-18
  • Corresponding author: Yuanzhen Zhang
引用本文:

黄林杰, 郭娟娟, 张元珍. HELLP综合征并发脑出血一例[J]. 中华产科急救电子杂志, 2018, 07(01): 58-61.

Linjie Huang, Juanjuan Guo, Yuanzhen Zhang. A case report of HELLP syndrome complicated with cerebral hemorrhage[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2018, 07(01): 58-61.

图1 HELLP综合征并发脑出血患者剖宫产术后脑部CT平扫图。A 图箭头所指处右侧颞叶见团片状高密度影(最大层面约64 mm×37 mm),周围可见低密度影环绕;B图箭头所指处两侧脑室、左侧额顶叶脑沟可见高密度铸型,中线结构左偏
图2 HELLP综合征并发脑出血患者剖宫产术后脑部CT图。A 图箭头所指处右侧颞叶见团片状高密度影(最大层面约48 mm×21 mm),B图箭头所指处右侧侧脑室受压变扁,中线结构稍显左偏,与前片(4月8日)比较,右侧颞叶血肿较前范围减小,密度减低,双侧脑室内积血吸收
图3 HELLP综合征并发脑出血患者剖宫产术后脑CT血管造影图。A、B图圈出处双侧颈内动脉颅内段、椎基底动脉、大脑中动脉、大脑前动脉及后动脉主干及分支血管均未见明显异常
[1]
Gedik E, Yucel N, Sahin T, et al. Hemolysis, elevated liver enzymes, and low platelet syndrome: Outcomes for patients admitted to intensive care at a tertiary referral hospital [J]. Hypertens Pregnancy, 2017, 36(1): 21-29.
[2]
解珺淑,陈哲,黄振宇,等. 重度子痫前期、HELLP综合征合并上消化道大出血一例[J/CD]. 中华产科急救电子杂志,2015, 4(4):254-256.
[3]
Lin L, Tsui K, Cheng J, et al. Increased Risk of Intracranial Hemorrhage in Patients With Pregnancy-Induced Hypertension [J]. Medicine, 2016, 95(20): e3732.
[4]
Yoshida K, Takahashi JC, Takenobu Y, et al. Strokes Associated With Pregnancy and Puerperium: A Nationwide Study by the Japan Stroke Society[J]. Stroke, 2017, 48(2): 276-282.
[5]
Block HS. Neurological complications of pregnancy [J]. Current Neurology and Neuroscience Reports, 2016, 16(7): 67.
[6]
Malte AL, Uldbjerg N, Wright D, et al. Prediction of severe pre-eclampsia by a combination of sFlt-1, CT-pro ET1 and blood pressure: exploratory study [J]. Ultrasound Obstet Gynecol, 2017. doi: 10.1002/uog.17561
[7]
Saleh L, van den Meiracker AH, Geensen R, et al. sFlt-1 and PlGF kinetics during and after pregnancy in women with suspected or confirmed preeclampsia [J]. Ultrasound Obstet Gynecol, 2017. doi: 10.1002/uog.17547.
[8]
Martin JJ, Owens MY, Keiser SD, et al. Standardized Mississippi Protocol treatment of 190 patients with HELLP syndrome: slowing disease progression and preventing new major maternal morbidity [J]. Hypertens Pregnancy, 2012, 31(1): 79-90.
[9]
Mathew M, Salahuddin A, Mathew NR, et al. Idiopathic intracranial hypertension presenting as postpartum headache [J]. Neurosciences (Riyadh), 2016, 21(1): 52-55.
[10]
梁竹巍,蔺莉,冯力民,等. 妊娠合并脑出血的临床特征和影响预后的相关因素分析[J]. 中华围产医学杂志,2016, 19(3):206-211.
[11]
Fairhall JM, Stoodley MA. Intracranial haemorrhage in pregnancy [J]. Obstetric Medicine: The Medicine of Pregnancy, 2009, 2(4): 142-148.
[12]
Tremblay E, Therasse E, Thomassin-Naggara I, et al. Quality initiatives: guidelines for use of medical imaging during pregnancy and lactation [J]. Radiographics, 2012, 32(3): 897-911.
[13]
Zhang JM. Guidelines for diagnosis and management of aneurysmal subarachnoid hemorrhage: top issues and prospective [J]. Zhejiang Da Xue Xue Bao Yi Xue Ban, 2015, 44(4): 357-360.
[14]
Edlow AG, Edlow BL, Edlow JA. Diagnosis of acute neurologic emergencies in pregnant and postpartum women [J]. Emerg Med Clin North Am, 2016, 34(4): 943-965.
[15]
Fukuda K, Hamano E, Nakajima N, et al. Pregnancy and delivery management in patients with cerebral arteriovenous malformation: a single-center experience [J]. Neurol Med Chir (Tokyo), 2013, 53(8): 565-570.
[16]
Connolly EJ, Rabinstein AA, Carhuapoma JR, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Association [J]. Stroke, 2012, 43(6): 1711-1737.
[17]
Cecati M, Sartini D, Pozzi V, et al. Clues to apoptosis pathway involvement in hemolysis, elevated liver enzyme, and low platelet (HELLP) syndrome and intrauterine growth restriction (IUGR)[J]. J Matern Fetal Neonatal Med, 2013, 26(1): 26-31.
[18]
Basaran B, Celebioglu B, Basaran A, et al. Anesthetic practices for patients with preeclampsia or HELLP syndrome: A survey [J]. J Turk Ger Gynecol Assoc, 2016, 17(3): 128-133.
[19]
Koyama S, Tomimatsu T, Kanagawa T, et al. Spinal subarachnoid hematoma following spinal anesthesia in a patient with HELLP syndrome [J]. Int J Obstet Anesth, 2010, 19(1): 87-91.
[20]
Leffert LR, Clancy CR, Bateman BT, et al. Hypertensive disorders and pregnancy-related stroke: frequency, trends, risk factors, and outcomes [J]. Obstet Gynecol, 2015, 125(1): 124-131.
No related articles found!
阅读次数
全文


摘要