妊娠期肝内胆汁淤积症对妊娠结局的影响.pdfVIP

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 (P0．01)，终止妊娠时间明显少于 轻度孕妇 (P0．01)。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(P0．01)。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：A DOI：10．3969／j．issn．1003．1383．2014．04．011 Effectofintrahepaticcholestasisofpregnancyonoutcomeofpregnantwomen WEN Yuting (TheSecondPeople’sHospitalofGuilin，Guilin541001，Guangxi，China) 【Abstract】 Objective Toana1)zetheeffectofintrahepatieeholestasisofpregnancy(ICP)ontheoutcomeofbothmoth— ersandbabies．M ethods 139casesofICPpregnantwomenwerecollectedinouthospita1．Accordingtotheclinicalgrading stna dards，hteyweredividedinto94casesofmildICP nad45casesofsevereICP．Then，theoutcomeofmothersandbabies ofthetwoabove—mentionedtypeswerecompared．Results Ratesofcesareansectionandpostpartum hemorrhageinpregnant womenwihtsevereICPweresingificantlyhigherthanthoseoftheprengnatwomenwithmildICP(P0．01)，andhteirtime ofprengancyterminationwasshorter(P0．01)．Incidenceoffetaldistress，prematurechildren，amnioticfluidcontamination， lowbirthweightinfantandturningtoNICUinsevereICPrgoupweresignificantlyhihgerthanthoseinmildICPgroup(P 0．05or0．01)．But1minApgrascoreofthesevereICPgroupwassignificantlylowerorlessthanthatinmildICPgroup( 尸0．01)．Conclusion ComparingwiththemildICP，ithasadverseeffectOilmothersandbabiesinthesevereICP．Itshould beenhancedprengnacycraenadtimelyterminationofpregnancytoreducetheincidenceofcomplicat