妊娠期急性脂肪肝16例诊疗分析.pdfVIP

342 解放军医学院学报 Acad J Chin PLA Med Sch Apr 2015，36（4） 妊娠期急性脂肪肝16 例诊疗分析 白　桦，胡凌云，魏永芹，高志英，周新月，于　丹，孟元光 解放军总医院 妇产科，北京　100853 摘要 ：目的 探讨妊娠期急性脂肪肝 (acute fatty liver of pregnancy，AFLP) 的临床诊疗及预后。方法 回顾性分析 2009 年 12 月 - 2014 年 7 月本院收治的 16 例 AFLP 临床资料。结果 16 例发病孕周 30+5 ~ 40+2(35.2±2.7) 周，经保肝、补充凝血因子、 手术等综合治疗，14 例好转出院，2 例出院后死亡，在我院分娩新生儿 14 例，死亡 1 例。结论 早期诊断、及时终止妊娠、 多学科合作、综合治疗是改善孕产妇及新生儿预后的关键。 关键词 ：妊娠期急性脂肪肝 ；早期诊断 ；治疗 中图分类号：R 711.71　文献标志码：A　文章编号：2095-5227(2015)04-0342-04　DOI ：10.3969/j.issn.2095-5227.2015.04.011 网络出版时间：2014-12-25 11:05　　　 网络出版地址 ：/kcms/detail/11.3275.R1105.001.html Diagnosis and treatment of acute fatty liver during pregnancy: A report of 16 cases BAI Hua, HU Lingyun, WEI Yongqin, GAO Zhiying, ZHOU Xinyue, YU Dan, MENG Yuanguang Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beij ing 100853, China Corresponding author: MENG Yuanguang. Email: meng6512 @ Abstract: Objective To study the clinical diagnosis, treatment and prognosis of acute fatty liver during pregnancy (AFLP). Methods Clinical data about 16 AFLP patients admitted to our hospital from December 2009 to July 20 14 were retrospectively analyzed. Results The mean maternal age of 16 AFLP patients were 35.2 ±2.7 weeks (range, 30+5- 40+2 weeks), after the treatment of liver-protective drugs, coagulation factors and surgery, 14 cases survived and 2 died after discharged. 14 newborns were born in our hospital and 1 case died. Conclusion Early diagnosis, timely termination of pregnancy, multidisciplinary collaboration and combined treatment are important in ensuring a successful maternal and fetal outcome. Keywords: acute fatty liver of pregnancy; early diagnosis; therapy 妊娠期急性脂肪肝 (acute fatty liver of pregnancy， 收治的明确诊断为 AFLP 的患者 16 例。诊断标准 AFLP) 是一种少见、发病于妊娠晚期的急性肝脂肪 参见曹泽毅主编《中华妇产科学》[1] 。随访时间为 变性，以肝细胞内含有大量脂肪微囊泡为特征 [1] ， 2014 年 10 月 7 日。 发病率为 1/7 000 ~ 1/16 000[