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目的探讨镜像综合征的临床特征及治疗方法。方法回顾性分析2007年8月至2012年5月于中山大学附属第一医院收治的8例镜像综合征患者临床资料,包括母体一般情况、实验室检查指标及超声检查、产后大体检查、胎盘病理及母儿围产结局。结果镜像综合征的临床表现以母体水肿、高血压、蛋白尿、稀释性贫血、低蛋白血症、胎儿水肿及胎盘水肿为特征。严重者出现胸水、腹水、肺水肿和心衰。此类患者产后出血、输血、转重症监护病房比例高。本组8例分娩前血红蛋白(HB)、红细胞压积(HCT)及血白蛋白(ALB)均降低,分别为(77.38±9.10)g/L、0.246±0.029及(24.86±3.10)g/L;终止妊娠后HB、HCT及ALB明显改善,分别为(99.27±15.27)g/L、0.308±0.046及(29.59±3.13)g/L,分娩后与分娩前相比较差异有统计学意义(P<0.05)。8例患者终止妊娠后母体症状迅速改善并全部痊愈出院。结论镜像综合征与子痫前期诊断易混淆,其中稀释性贫血是鉴别诊断要点。确诊镜像综合征后,可予纠正低蛋白血症和合理使用利尿剂,严格限制液体入量,尽早终止妊娠,预防产后出血等处理。终止妊娠是治疗镜像综合征的根本方法。
Objective To investigate the clinical features and treatment of mirror syndrome. Methods The clinical data of 8 patients with MIRS who were admitted to the First Affiliated Hospital of Sun Yat-sen University from August 2007 to May 2012 were analyzed retrospectively, including the general condition of the maternal, laboratory indexes and ultrasonography, postpartum general examination, placental pathology And mother and child perinatal outcome. Results The clinical manifestations of MIRS were characterized by maternal edema, hypertension, proteinuria, dilutional anemia, hypoproteinemia, fetal edema and placental edema. In severe cases, pleural effusion, ascites, pulmonary edema and heart failure. Such patients postpartum hemorrhage, blood transfusion, intensive care intensive care unit. The hemoglobin (HB), hematocrit (HCT) and albumin (ALB) of 8 patients before delivery were all decreased in the groups of (77.38 ± 9.10) g / L, 0.246 ± 0.029 and (24.86 ± 3.10) g / L (99.27 ± 15.27) g / L, 0.308 ± 0.046 and (29.59 ± 3.13) g / L respectively after termination of pregnancy, and the difference was statistically significant after delivery <0.05). After termination of pregnancy in 8 patients, maternal symptoms improved rapidly and all were cured. Conclusions Mirrored syndrome is easily confused with the diagnosis of preeclampsia, of which dilutional anemia is the main point of differential diagnosis. Confirmed mirror syndrome, can be corrected hypoproteinemia and rational use of diuretics, strictly limit liquid intake, termination of pregnancy as soon as possible, prevention of postpartum hemorrhage and other treatment. Termination of pregnancy is the fundamental method of treatment of mirror syndrome.