... 26 86274 10/20/99 8 3 3 LMP20/240 20 4 3 1 0
Bp 22/14kpa, ++ BBpD8.8cm,6.8cm, 4.0cm, II HCT 0.35,Hb 121g/L,PLT 212G/L + + BUN5.7mmol/L,Cr 78mmol/L,???
hypertensive disorder complicating pregnancy...
Definition
.
BP 140/90mmHg 12 BP 140/90mmHg20300mg/24h + BP 160/110mmHg 2.0g/24h++ 106 mol/l 100 10 9 /LLDH ALT AST 20 300mg/24h 20 100 10 9 /L BP 140/90mmHg 20 20 12
160~180mmHg 110 mmhg 245g 24500ml ALT AST
1~1.5
Diagnosis 1. 2. 3. 4. 5.
1 2 140mmHg 90mmHg 6 20
3 24 300mg6 0.1g/L(+) 92%24 4 0.9kg/ 2.7kg/ + ++ +++ ++++
5 1 Hb HCT 2 ALT AST / BUN CrCr CO 2
31.020 + 300mg/24 ++++ 5g/24 4 5
Treatment
1 10 2.5~5mg tid5mg 2
2
1 Mg ++ Mg ++ Mg ++ Mg ++
2
3 25%MgSO 4 20ml + 10%GS 20ml iv 5~10min) 25%MgSO 4 60ml + 5%GS 500ml iv drop 1~2g/h 25%MgSO 4 20ml + 2% 2ml 1~2 25~30g
4 0.75~1.0mmol/L, 1.7~3.0mmol/L >3.0mmol/L
5 16 25ml/h 600ml/24h Ca 10% 10ml iv st NC Mg ++ 24
160/110 mmhg 110 mmhg 140mmHg
1
2
3 4
5 α 6
24~48h 34 34 34 2
24h 10
3 1 25% 20ml + 25%Glu20ml iv5min2g/h 20% 250ml 2 3 CO 2 4% NaHCO 3 4 2h
HELLP DIC
MAP=+ 2 /3 MAP 85mmHg MAP 140mmHg ROT 5 20mmHg
HCT 0.35 3.61.6 CaCa/Cr 0.04
18 40 T 235
NK
Ab- TCX NK TNF- IL-1-1 HLA-DR 4 HLA
HLA-DR 4
-6 NO EDRF PGI 2 A 2 TXA 2
T 235 Leiden
EC
NO E 2
1~2g
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