妊娠期急性脂肪肝14例临床分析

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1、妊娠期急性脂肪肝14例临床分析［摘要］目的分析妊娠期急性脂肪肝患者的临床表现特征，并追踪妊娠结局，了解疾病的转归。方法回顾性分析妊娠期急性脂肪肝14例,记录临床资料，包括•一般情况如年龄、孕周、是否初产妇等以及临床表现、相关检查、并发症及妊娠结局等。结果妊娠期急性脂肪肝患者的发病孕周为(34.72±2.51)周，城市人口较多，占78.6%。患者中大部分为初产妇，占92.9%0临床表现以黄疸、血肌酹升高、消化道症状、胆酶分离等为主；并发症则表现为急性肾功能不全的发生率最高，其次为弥散性血管内凝血(DIC)、肝性脑病、产后出血等。妊娠结局：孕母死亡、早产、死胎、新生儿窒息的发生率较高。

2、结论妊娠期急性脂肪肝好发于妊娠晚期,常伴有严重的并发症，对母胎影响大，在临床工作中应注意及时诊断、治疗。［关键词］妊娠期急性脂肪肝；妊娠；弥散性血管内凝血［中图分类号］R714.255［文献标识码］B［文章编号］1674-4721(2014)09(c)-0162-03Clinicalanalysisof14caseswithacutefattyliverofpregnancyCHENXinMENGLi~liFUShuaiLIUMei-IanZHANGJian-pingDepartmentofGynaecologyandObstetrics,SunYat-SenMemorialHos

3、pitalofSunYat-SenUniversity,Guangzhou510120,China[Abstract]ObjectiveToanalyzetheclinicalmanifestationfeatureofpatientswithacutefattyliverofpregnancy，andtrackthepregnancyoutcomeandknowtheprognosisofthedisease.Methods14caseswithacutefatty1iverofpregnancywereretrespectivelyanalyzed,withclinicalda

4、taincludingthegeneralsituation(suchasage,gestationalage,whetherprimipara,etc),clinicalmanifestations，relevantexamination,complicationsandpregnancyoutcomesandsoonworerecorded.ResultsPregnancygestationalageatonsetinpatientswithacutefattyliverwas(34.72±2.51)weeks,theurbanpopulationwasmore(account

5、ingfor78.6%)・Mostofthepatientsareprimiparas(accountingfor92.9%).Themainclinicalmanifestationswerejaundice,elevatedserumcreatinine,gastrointestinalsymptoms,bileenzymeseparationandsooon,andcomplicationsarecharacter!zedbythehighestincidencerateofacuterenalinsufficiency,followedbydisseminatedintra

6、vascularcoagulation,hepaticencephalopathy,postpartumhemorrhage,etc.Pregnancyoutcomes：theincidencerateofmotherhooddeath,prematurebirth,stillbirth,andneonatalasphyxiawerehigher.ConclusionAcutefatty1iverofpregnancyshouldbepaidattentiontotimelydiagnosistreatmentinclinicalwork,anditappearsmostlyatl

7、atepregnancyoftenassociatingwithseriouscomplications，andithasagreaterimpactonmotherandthefetus.[Keywords]Acutefattyliverofpregnancy；Pregnancy；Disseminatedintravascularcoagulation妊娠期急性脂肪肝(acutefattyliverofpregnancy,AFLP)是妊娠期特有疾病之一。1996年报