妊娠期急性脂肪肝产后肝肾功能及凝血功能的变化  

The changes of liver,renal functions and coagulation in patients with acute fatty liver of pregnancy after delivery

作　　者：陈大立[1,2] 许慧[1,2] 彭兰[1,2] 程琛[1,2] 赵富丽[1,3] 柴立强[1,2] 

机构地区：[1]南京医科大学附属苏州医院 [2]苏州母子医疗保健中心产科,江苏省215000 [3]苏州母子医疗保健中心ICU,江苏省215000

出　　处：《江苏医药》2014年第19期2289-2292,共4页Jiangsu Medical Journal

摘　　要：目的探讨妊娠期急性脂肪肝(AFLP)患者终止妊娠后肝肾功能及凝血功能的变化。方法明确诊断AFLP患者19例,予以改善凝血功能后即刻终止妊娠。回顾性分析患者产后肝肾功能及凝血功能各指标变化。结果 19例AFLP患者产后AST和ALT恢复较快,产后4d接近正常;血清总胆红素(TBil)恢复较慢;血清肌酐(SCr)于产后3d开始下降,7d基本恢复正常;产后1周血小板开始回升;产后3d凝血酶原时间逐渐缩短,1周恢复正常;纤维蛋白原降低明显,恢复缓慢,产后5d逐渐上升。结论 AFLP患者有肝肾功能损害和凝血功能变化,终止妊娠后经综合治疗1周左右均可逐渐恢复正常。Objective To explore the features of changes in liver and renal functions and coagulation in the patients with acute fatty liver of pregnancy（AFLP） after delivery. Methods The pregnancy was stopped in 19 patients with AFLP soon after coagulation was improved. The features of the changes in liver and renal functions and coagulation after delivery were retrospectively analyzed. Results Serum levels of AST and ALT after delivery recovered quickly, which returned to nearly normal on the 4th day. Serum total bilirubin level recovered slowly. Serum creatinine level came down on the 3rd day and returned to normal level one week or so. Platelet count began to rise one week later. Prothrombin time began to shorten on the 3rd day and returned to normal level one week later. Fibrinogen decreased significantly after delivery, which recovered slowly started on the 5th day. Conclusion The liver and renal functions and coagulation in AFLP patients are injured, which after comprehensive therapy can return to the normal in one week or so after delivery.

关 键 词：妊娠 急性脂肪肝 肝功能 肾功能 凝血功能 

分 类 号：R714[医药卫生—妇产科学]