妊娠期肝内胆汁淤积症的分度管理及妊娠结局探讨-论文.pdf

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1、际医药卫生导报2013年第l9卷第20期IMHGN，October2013，v01．19N0．2()妊娠期肝内胆汁淤积症的分度管理及妊娠结局探讨李超容严勤伍碧梅【摘要】目的探讨妊娠期肝内胆汁淤积症(ICP)患者分度管理后的妊娠结局。方法将142例围生期ICP患者以既定生化指标值为限，取轻度患者104例，重度患者38例，分为A、B两组，A组(实验组)：轻度(A1)52例，重度(A2)19例；B组(对照组)：轻度(B1)52例，重度(B2)19例。A组按分度诊断、处理：A1组患者在孕41周之前，期待自然临产、阴道试产。A2组患者提前干预，计划剖宫产术终止妊娠。B组则不采

2、用分度处理，全执行门诊或住院后的爪l性化治疗。观察两组的妊娠结局。结果A、B两组1CP患者中，A组低体重儿11．3％、羊水粪染率11．3％、新生儿窒息率5．6％、剖宫产率32．4％、产后出血率5．6％。B组低体重儿19．7％、羊水粪染率15．5％、新生儿窒息率15．5％、剖宫产率64．8％、产后Hj血率9．9％。A、B两组比较差异有统计学意义(P<0．05)。结论对ICP患者进行分度诊断和相应的合理处理，可以改善妊娠结局。【关键词】妊娠；胆汁淤积症；分度管理；妊娠结局Researchondividingmanagementonintrahepaticcholesta

3、sisduringpregnancyandthepregnancyoutcomeLIChao—Rong,YANQi．．WUBi—Met．GynaecologyandObstetricsDepartment,The2ndPeople’SHospitalofJiangmen，Jiangmen529030,China【Abstract】ObjectiveToprobetheoutcomeofintrahepaticcholestasisduringpregnan<·y(ICP)inpatientswithpregnancyafterdividingmanagement．M

4、ethods142patientswithICPintheperinatalperiodwerelimitedtoestablishbiochemicalindexes．Thesepatientsweredividedintotwogroups：groupAwith104mildpatients(experimentalgroup)，groupBwith38severepatients(controlgroup)．Theexperimentalgroupinchnted52mildeases(A1)and19severeeases(A2)．Thegradingdia

5、gnosisandtreatmentwereusedingroupA．ThepatientsingroupA1wereexpectedtonaturallaborandvaginaltrialproductionbefore41weeksgestation，andthepatientsingroupA2weretreatedwithearlyinterventionandplannedcesareansectionterminationofpregnancy．ThepatientsinGroupBweretreatedwithoutgradingdiagnosisa

6、ndtrealmen1．ThepersonalizedtreatmentwasiJsedingroupB．Thepregnancyoutcomeofthesetwogroupswasobserved．ResultsBetweenthesetwogroups，therewere11．3％oflow—birthweightinfants．11．3％ofamniotiefluidturbidity．5．6％ofneonatalasphyxia，32．4％ofcesareandeliveryand5．6％ofpostpartumhemorrhageingroupA：whil

7、etherewerel9．7％oflowbirthweightinfants．15．5％ofamniotiefluidturbidity．15．5％ofneonatalasphyxia．64．8％of(esareandeliveryand9．9％ofpostpartumhemorrhageingroupB．showingmorestatisticalsignificantdifferencef，J<0．05)．ConclusionGradingdiagnosisandcorrespondingpropertreatmenttopatientswithICPcan