妊娠急性脂肪肝的早期诊断及其处理(附15例分析)  被引量:1

Early diagnosis and treatment of acute fatty liver of pregnancy (Attached 15 cases)

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作  者:张庆英[1] 蒋佩茹[1] 孙媛[1] 

机构地区:[1]复旦大学附属公共卫生中心妇产科,上海201508

出  处:《世界感染杂志》2006年第1期58-60,共3页World Journal of Infection

摘  要:目的探讨妊娠急性脂肪肝(AFLP)的早期诊断方法和处理原则。方法对上海市公共卫生中心及原上海市传染病医院孕肝中心17年来收治的15例妊娠急性脂肪肝进行回顾分析。结果AFLP死亡率为20.0%,86.6%的病人有临床症状。体征为黄疸(93.3%)、水肿(53.3%)和腹水(40.0%)。产科并发症为产后出血(26.6%),弥漫性血管内凝血(26.6%),肾功能衰竭(93.3%),肝性脑病(53.3%),胎儿窘迫(40.0%)。死胎(20.0%).实验室检查:血清丙氨酸氨基转移酶(ALT).天冬氨酸氨基转移酶(AST)、总胆红素(TB)、直接胆红素、尿素氮、肌酐、尿酸和白细胞升高,血小板降低。12例剖官产终止妊娠,占80.0%.结论AFLP是一种妊娠后期特有的急危重病,早期诊断、积极有效的治疗与及时合理的产科处理,可提高生存率。Objective To explore the diagnosis and therapy of acute fatty liver of pregnancy (AFLP). Methods 15 Cases of acute fatty liver of pregnancy in shanghai public health center have been retrospective analyzed. Results The mortality rate of AFLP reached 20.0%. The patients with clinical symptoms were 86.6%. The signs of AFLP were jaundice (93.3%), edema (53.3%) and ascites (40.0%). The obstetrics complications of AFLP were postpartum hemorrhage (26.6%), DIC (26.6%), renal failure (93.3%), hepatic encephalopathy (53.3%), fetal distress (40.0%), and fetal death (20.0%). Laboratory abnormality included elevated ALT, AST, total bilirubin, direct bilirubin, BUN, creatinine, uric acid, Leukocytosis and degraded playlet count. The termination of pregnancy of 12 cases was with the uterine-incision delivery. Conclusion AFLP is an acute and severe complication of pregnancy anaphase. Early diagnosis, effective therapy and reasonable obstetrics treatment in time could improve survival rate.

关 键 词:妊娠急性脂肪肝 早期诊断 处理 

分 类 号:R575.5[医药卫生—消化系统]

 

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