妊娠期肝内胆汁淤积症围生结局探讨  

Explore the Pregnancy Outcome of Interahepatic Choloestasis of Pregnancy

作　　者：张玉荣[1] 张春华[1] 严丽华[1] 吴向坤[1] 

机构地区：[1]南阳市第二人民医院妇产科,南阳473012

出　　处：《中国医药导刊》2009年第6期941-942,944,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨妊娠期肝内胆管淤积症(Intrahepatic Cholestasisof Pregnancy,ICP)的母儿围生结局和终止妊娠的预测指标。方法:将我院近10年收治的71例ICP患者作为研究组,并设立对照组进行比较。在研究组中分为治疗组与未治疗组进行对比分析。分析终止妊娠相关因素的发生率,探讨终止妊娠的预测指标。结果;①研究组母亲的围生结局中早产、产后出血、剖宫产的发生率均高于对照组(P<0.05);给予干预治疗后,治疗组早产、产后出血的发生率低于未治疗组(P<0.05),剖宫产的发生率无明显差异(P>0.05)。②研究组的围生儿结局中胎儿宫内窘迫、低质量儿的发生率高于对照组;给予干预治疗后,治疗组胎儿宫内窘迫、低质量儿的发生率低于未治疗组(P<0.05),围生儿死亡率无明显差异(P>0.05)。③在终止妊娠的相关因素中,TBA持续升高,肝酶和胆红素升高,NST无反应型,脐动脉S/D>3.0,羊水减少或粪染,胎儿宫内窘迫在研究组中的发生率高于对照组(P<0.05)。结论:ICP患者可导致母亲和围生儿不良的结局,尤其以胎儿危害为重;经干预治疗后可部分改善母亲和围生儿的结局;在终止妊娠的相关因素中,应把TBA持续升高,肝酶和胆红素升高,NST无反应型,脐动脉S/D>3.0,羊水减少或粪染,胎儿宫内窘迫作为ICP患者终止妊娠的参考指征。Objective： To investigate the maternal and fetal pregnancy outcome of Intrahepatic cholestasis of pregnancy（ICP）and the predictors in the termination of pregnancy.Methods： To take 71 cases treated ICP patients as study group in my hospital for nearly 10 years ,and compare to the control group.In the study group divided into treatment group and non-treatment group.To Analyse the incidence of factors in termination of pregnancy, and investigate the predictors in the termination of pregnancy Results：①the perinatal outcome of mothers as premature labor, postpartum hemorrhage and cesarean section in the study group were higher than the control group（P〈0.05）; after the intervention given to treatment group,the incidence of premature birth and postpartum hemorrhage lower than non-treatment group（P〈0.05）, the incidence of cesarean section has no significant difference（P〉0.05）.② The perinatal outcome of fetal as fetal distress in uterus and low birth weight infants in the study group were higher than the control group（P〈0.05）,after the intervention given to treatment group,the incidence of fetal distress in uterus and low birth weight infants lower than non-treatment group（P〈0.05）.the perinatat mortality has no significant difference（P〉0.05）.③In the termination of pregnancy-related factors： TBA rising,elevated liver enzymes and bilirnbin,NST non- reactive,umbilical artery S / D〉 3.0,amniofic fluid reduce or meconium-stained amnintic fluid, fetal distress in the study group higher than control group（P〈0.05）.Conclusion： ICP patients can lead to maternal and perinatal adverse outcome,in particular hazard to the fetus ; the treatment could be partly improving the matemal and perinatal outcome; In the termination of pregnancy-related factors： to take TBA rising,elevated liver enzymes and bilirubin,NST non-reactive,umbilical artery S/D〉 3.0,amniotic fluid reduce or meconium-stained amniotic fluid, fetal distress as a referenced indications for termination of pr

关 键 词：妊娠期肝内胆管淤积症 围生结局 终止妊娠 预测指标 

分 类 号：R714.7[医药卫生—妇产科学]