妊娠期肝内胆汁淤积症118例诊治研究及妊娠结局.docVIP

妊娠期肝内胆汁淤积症118例诊治研究及妊娠结局 　　doi：10.3969/j.issn.1007-614x.2014.19.31 　　摘 要 目的：观察妊娠期肝内胆汁淤积症（ICP）的临床症状，分析其对母婴的危害及降低胎儿宫内死亡、新生儿窒息、早产的有效治疗方法。方法：2008年1月-2013年6月收治ICP患者118例，对其临床资料进行回顾性分析，总结其临床特点、分娩方式、产后出血量及妊娠结局。结果：118例ICP患者中，剖宫产81例，阴道分娩37例。其中早产25例（21.2%），胎儿窘迫19例（16.1%），新生儿窒息12例（10.2%）。ICP发病时间越早，其肝损伤越严重，危害越大。新生儿外观均无畸形，其中1例高危儿转新生儿科治疗后因多脏器功能衰竭死亡。通过与另外的50例治疗组对照发现，治疗对改善母婴健康有着显著的改善作用。结论：ICP易引起胎儿宫内缺氧、早产、胎儿宫内窘迫及新生儿窒息，对母婴危害较大。早诊断、早治疗、加强胎心监护及适时终止妊娠可有效降低新生儿危害，提升母婴健康。 　　关键词 妊娠期肝内胆汁淤积症 胎儿窘迫 早产 妊娠结局 　　Clinical research and pregnancy outcome of 118 cases of intrahepatic cholestasis of pregnancy 　　Liang Meiyan，Luo Yiping，Ouyang Xiaohong 　　Department of Gynecology，the First Peoples Hospital of Shunde District，Foshan City，Guangdong 528300 　　Abstract Objective：To observe the clinical symptoms of intrahepatic cholestasis of pregnancy（ICP）.To analyze its harm of maternal and child and the effective treatments of reducing the fetal death，neonatal asphyxia，premature delivery.Methods：118 cases with intrahepatic cholestasis of pregnancy were selected from January 2008 to June 2013.The clinical data were retrospectively analyzed.The clinical characteristics，delivery mode，postpartum hemorrhage and pregnancy outcome were summarized.Results：In the 118 ICP cases，81 cases were cesarean section，and 37 cases were vaginal delivery.25 cases（21.2%） were premature delivery，19cases （16.1%） were fetal distress，and 12 cases（10.2%） were neonatal asphyxia.ICP onset time was more early.The liver damage was more serious，and the harm was more greater.Neonatal appearance had no abnormalities.1 case high risk infant was died because of multiple organ failure after new pediatric treatment.Through the comparison with another 50 cases of the treatment group，it found that the treatment had significant improvement on the maternal and child health.Conclusion：ICP can cause intrauterine fetal anoxia，premature delivery，fetal distress and neonatal asphyxia，which has a great harm to the maternal and child.The early diagnosis