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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