妊娠肝内胆汁淤积症分度诊断和处理临床意义.docVIP

妊娠肝内胆汁淤积症分度诊断和处理临床意义 　　摘要：目的 分析妊娠期肝内胆汁淤积症分度诊断和临床处理的意义。方法 回顾分析2012年8月～2016年2月在我院治疗的80例妊娠肝内胆汁淤积症（ICP）患者临床资料，依据患者血清胆红素，肝转氨酶和胆汁酸水平将其分为轻度与重度ICP，并进行分度诊断和分度处理，观察妊娠结局与分度诊断前后的围生儿病死率。结果 重度组和轻度组终止妊娠孕周差异有统计学意义（P0.05）；重度和轻度分度诊断治疗时间差异有统计学意义（P0.05）；重度组新生儿羊水粪染、窒息发生率明显高于轻度组，差异有统计学意义（P0.05）；采用分度治疗围生儿病死率明显低于同期未采用分度治疗的围生儿病死率，差异有统计学意义（P0.05）。结论 临床对ICP患者进行分度诊断和相应处理，可以明显改善围生儿预后效果，值得在临床推广和应用。 　　关键词：妊娠并发症；肝内胆汁淤积症；诊断和处理 　　Abstract：Objective To analyze the significance of the diagnosis and treatment of intrahepatic cholestasis of pregnancy. Methods A retrospective analysis was made in August 2012 to 2016 during the month of February in our hospital treatment of 80 cases of pregnancy intrahepatic cholestasis of pregnancy （ICP） in patients with clinical data， according to the patients serum bilirubin and liver transaminase and bile acid levels will be the mild and severe ICP， and grading diagnosis and grading treatment， observed the pregnancy outcome and grading diagnosis before and after the perinatal mortality rate. Results Severe group and mild group terminated gestational week difference was statistically significant （P0.05）； severe and mild indexing in diagnosis and treatment of time difference was statistically significant （P0.05）； neonatal meconium stained amniotic fluid and asphyxia incidence was significantly higher than that of the mild group， the difference is statistically significant （P0.05）； by dividing the treatment of peri neonatal mortality rate significantly lower than the same period the indexing treatment of perinatal mortality rate， the difference is statistically significant （P0.05）. Conclusion Clinical diagnosis and treatment of ICP patients， can significantly improve the prognosis of perinatal infants， it is worth in clinical promotion and application. 　　Key words：Pregnancy complications；Intrahepatic cholestasis； Diagnosis and treatment 　　妊娠期肝胆内胆汁淤积症（ICP）是妊娠中晚期特有的并发症，临床患者主要以皮肤瘙痒、黄疸为特征。该疾病孕妇预后良好主要会危及胎儿，容易引起早产、胎儿宫内窘迫、死胎、死产等严重后果，因此临床早期给予有效地分度诊断和处理具有重要的临床意义[1]。目前临床对ICP