妊娠期肝内胆汁淤积症患者的分娩方式探讨-论文.pdf

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1、国盐生育和妇产科2014年第6卷第5期·69·妊娠期肝内胆汁淤积症患者的分娩方式探讨李萍，陈红，赵虎，张强作者单位：610031四川成都，成都市妇女儿童中心医院产科作者简介：李萍，毕业于四川大学华西医学中心，主治医师，研究方向为围产医学通讯作者，E—mail：maplebeem@sina．com【摘要】目的研究妊娠期肝内胆汁淤积症(intrahepaticcholestasisofpregnancy，ICP)患者的分娩方式及妊娠结局。方法选取152例ICP孕妇为研究对象，分为轻度组83例，重度组69例；随机抽取80例同期经阴道分娩的正常孕妇为对照组，比较妊娠结局。结果经阴道分娩产妇胎儿窘迫、新

2、生儿窒息及围生儿死亡发生率重度ICP组高于轻度ICP组和对照组(P<0．05)；轻度ICP组与对照组围生儿不良结局比较，差异无统计学意义(P>0．05)。轻度ICP组阴道分娩与剖宫产分娩者比较，羊水粪染及新生儿窒息率差异无统计学意义(P>0．05)，剖宫产产妇产后出血率高于阴道分娩产妇(P<0．05)。结论轻度ICP患者可适当延长孕周，待产程发作后严密监测下经阴道试产，重度ICP适时剖宫产终止妊娠。【关键词】妊娠期肝内胆汁淤积症；阴道分娩；妊娠结局【中图分类号】R714．2【文献标志码】A【文章编号】1674—4020(2014)05—0069—03doi：10．3969／j．issn．167

3、4—4020．2014．05．21StudyondeliverymodesofpatientswithintrahepaticcholestasisofpregnancyHPingCHENttong，ZHAOHu，ZHANGQiangDepartmentofObstetrics，ChengduWomenandChildren’sCentralHospital，ChengduSichuan，610031，PR．ChinaCorrespondingauthor，E—mail：maplebeem@sina．com【Abstract】0bjectiveToresearchthedeliverymode

4、sandoutcomesofpatientswithintrahepaticcholestasisofpregnancy(ICP)．Methods152pregnantwomenwithICPwereselectedanddividedintomildICPgroupwith83casesandsevereICPgroupwith69cases．80normalpregnantwomenwithvaginaldeliverywererandomizedchosenascontrolgroup，thedeliveryoutcomesofthethreegroupswerecompared．Res

5、ultsThefetaldistress，neonatalasphyxiaandperinatalmortalityofvaginaldeliverycasesinsevereICPgroupwerehigherthanmildICPgroupandcontrolgroup(P<0．05)，nosignificantdifferenceinperinataladverseoutcomeswerefoundbetweenmildICPgroupandcontrolgroup(P>0．05)．Comparingwiththevaginaldeliverycasesandthecesareansec

6、tioncasesinmildICP，nosignificancedifferencewerefoundinmeconiumstainedamnioticfluidandneonatalasphyxiarate(P>0．05)，whilepostpartumhemorrhagerateincesareansectioncaseswashigherthanvaginaldeliver(P<0．05)．ConclusionPatientswithmildICPmaybeappropriatetoextendthegestationalweeksandtakevaginaldeliverybyclo

7、selymonitoraftertheonsetoflabor．PatientswithsevereICPmaytakecesareansectionatanappropriatetime．【KeyWords】intrahepaticcholestasisofpregnancy；vaginaldelivery；deliveryoutcome妊娠期肝内胆汁淤积症(intrahepaticcholes