近20年妊娠肝内胆汁瘀积症诊断及处理的变化  

Advances in Diagnosis and Treatment of Intrahepatic Cholestasis of Pregnancy During the Past Twenty Years

作　　者：周晓 郭春燕 

机构地区：[1]重庆市第四人民医院,重庆400014

出　　处：《实用妇产科杂志》2001年第5期276-278,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的 :探讨近 2 0年妊娠肝内胆汁瘀积症 (ICP)发病率及诊断、处理方法的变化。方法 :按每 5年为 1个时间段回顾性分析我院 1980年 1月至 1999年 12月间 2 40例 ICP的诊治情况 ,结果 :1ICP的发病率由 1980年至 1984年的0 .2 7%上升为 1995年至 1999年的 5 .37% (P<0 .0 5 )。 2诊断技术的改进 ,诊断规范化 ,特别是胆酸升高为 ICP的特异性生化指标 ,使 ICP确诊时间提前 ,当胆酸升高 >40 mg/L 时 ,羊水粪染率明显增加 (P<0 .0 1)。 3虽 ICP发病率明显上升 ,但胎儿宫内窘迫发生率并未随之增加 (P>0 .0 5 )。4分娩方式由阴道分娩逐渐过渡到以剖宫产结束分娩 (P<0 .0 1)。虽剖宫产率明显增高 ,但产后出血发生率并未增加 ,新生儿窒息率明显下降。结论 :ICP发生率增高 ,诊断规范化 ,血清胆酸检查辅以肝功能检查 ,缩短了确诊时间 ,剖宫产术是目前Objectives:To investigate the changes of diagnosis and treatrnent of Intrahepatil Cholestasis of Pregnancy (ICP) during the Past Twenty Years. Methods:Medical records of 240 cases with ICP in our hospital from Jan 1980 to Dec.1999 were collected and analyzed retrospectively.Results:①The incidence of ICP increases from 0.27%during 1980～1984to 5.37% during 1995～1999( P <0.05).②Diagnosis has been upgraded.As cholic acid has gone up to the superfine biochemitry level of ICP,so that short the time dlagnose when cholic acid was gone up to 40 mg/L or so, the incidence of amnionic fluid increases obviously( P <0.01).③The incidence of ICP increased obviously during past twenty years,but the incidence of fetal distress (fetal hypoxemia)did not increase with it(P>0.05).④The mode of delivery shift from vaginel delivery to caesarean section(P<0.01),and the incidence of hemorrhage after operation did not increase ,and theineidence of neonatal aschyxia deereased.Conclusions:Sream cholic acid was effective marker.The caesaream section is the most important way to prevent pregnancy outcome of ZCP.

关 键 词：妊娠合并症 肝内胆汁瘀积症 诊断 治疗 

分 类 号：R714.255[医药卫生—妇产科学]