妊娠期肝内胆汁淤积症对妊娠结局的影响-论文.pdf

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1、查'江医学2014年第42卷第4期ChineseYouiiangMedicalJouma12014，V01．42No．4·433-妊娠期肝内胆汁淤积症对妊娠结局的影响温玉婷(广西桂林市第二人民医院妇产科，桂林541001)【摘要】目的分析不同临床分度妊娠期肝内胆汁淤积症(ICP)对孕妇及胎儿结局的影响。方法按照相关文献I晦床分度标准将收治的139例ICP孕妇分为轻度ICP(94例)与重度ICP(45例)两种类型。比较两种类型ICP孕妇及胎儿结局。结果重度ICP患者剖宫产率、产后出血率均明显高于轻度孕妇(P<0．01)，终止妊

2、娠时间明显少于轻度孕妇(P<0．01)。重度ICP胎儿窘迫、羊水粪染、早产、低体重儿、转NICU的发生率均明显高于轻度孕妇(P<0．05或0．01)，而1分钟Apgar评分则明显低于轻度孕妇(P<0．01)。结论与轻度ICP相比，重度ICP孕妇及围产儿均有不良影响，需加强孕期监护、适时终止妊娠，以降低并发症发生率及围产儿死亡率。【关键词】妊娠期肝内胆汁淤积症；妊娠结局中图分类号：R714．255文献标识码：ADOI：10．3969／j．issn．1003．1383．2014．04．011Efectofintrahepatic

3、cholestasisofpregnancyonoutcomeofpregnantwomenWENYuting(TheSecondPeople’sHospitalofGuilin，Guilin541001，Guangxi，China)【Abstract】ObjectiveToana1)zetheefectofintrahepatieeholestasisofpregnancy(ICP)ontheoutcomeofbothmoth—ersandbabies．Methods139casesofICPpregnantwomenwe

4、recollectedinouthospita1．Accordingtotheclinicalgradingstandards，theyweredividedinto94casesofmildICPand45casesofsevereICP．Then，theoutcomeofmothersandbabiesofthetwoabove—mentionedtypeswerecompared．ResultsRatesofcesareansectionandpostpartumhemorrhageinpregnantwomenwit

5、hsevereICPweresignificantlyhigherthanthoseofthepregnantwomenwithmildICP(P<0．01)，andtheirtimeofpregnancyterminationwasshorter(P<0．01)．Incidenceoffetaldistress，prematurechildren，amnioticfluidcontamination，lowbirthweightinfantandturningtoNICUinsevereICPgroupweresignif

6、icantlyhigherthanthoseinmildICPgroup(P<0．05or<0．01)．But1minApgarscoreofthesevereICPgroupwassignificantlylowerorlessthanthatinmildICPgroup(尸<0．01)．ConclusionComparingwiththemildICP，ithasadverseefectOilmothersandbabiesinthesevereICP．Itshouldbeenhancedpregnancycareand

7、timelyterminationofpregnancytoreducetheincidenceofcomplicationsandperinatalmot—tality．【Keywords】intrahepaticcholestasisofpregnancy；pregnancyoutcome妊娠期肝内胆汁淤积症(intrahepaticcholestasis例ICP孕妇临床资料进行回顾性分析，旨在为临床ofpregnancy．ICP)是一种妊娠中晚期特有的常见并防治提供参考。发症，临床主要症状为皮肤瘙痒、黄疸，伴有血清胆1

8、资料与方法汁酸、肝酶水平升高等肝功能生化指标异常_1]。虽然ICP孕妇一般预后较好、产后症状迅速消失，但对1．1入选标准参照乐杰主编的《妇产科学》中关围产儿危害较大，容易导致胎儿生长受限、宫内窘于ICP的诊断标准[：①妊娠中、晚期出现皮肤瘙迫、早产、新生儿颅内出血、新生儿窒息等并发症，严痒