100例妊娠期肝内胆汁淤积症妊娠结局的临床分析  

作　　者：陆佳红[1] 张薏[2] 洪敏[1] 李婷婷 韩凌珊 毛佩瑜 

机构地区：[1]浙江中医药大学第一临床医学院,310053 [2]浙江省中医院妇产科,310006 [3]浙江省台州市妇女儿童医院,318000

出　　处：《浙江临床医学》2017年第4期709-711,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨100例妊娠期肝内胆汁淤积症（1CP）患者的妊娠结局。方法对2013年3月至2016年3月期间住院分娩的100例ICP孕妇进行回顾性分析，根据总胆汁酸（TBA）、直接胆红素（DBIL）、总胆红素（TBIL）、谷丙转氨酶（ALT）、谷草转氨酶（AST）等指标。分为轻度（58例）和重度（42例），并随机抽取同期入院分娩的正常孕妇100例作为对照组，统计三组孕妇年龄、终止妊娠的孕周及分娩方式、皮肤瘙痒情况、确诊时间、早产、胎儿窘迫、新生儿窒息、羊水情况、入住新生儿监护病房（NICU）、围生儿死亡等临床资料。结果轻度组、重度组、对照组终止妊娠平均孕周分别为（37±1．6）周、（35±1．8）周、（39±1．2）周，剖宫产率分别为55．17％、85．71％、33％，羊水Ⅲ度（粪染）发生率分别为5．17％、38．09％、3％，三组差异均有统计学意义（P〈0．05）。轻度组、重度组平均确诊时间分为（31±1．5）周、（29±1．6）周，皮肤瘙痒发生率分别为82．76％、88．10％。轻度纽、重度组、对照组的早产率分别为39．66％、69．05％、10．00％，胎儿窘迫发生率分别为39．66％、76．19％、11．00％，新生儿窒息发生率分别为5．17％、45．24％、3．00％，新生儿入住NICU率分别为32．76％、76．19％、12．00％，差异均有统计学意义（P〈0．05）。围生儿死亡病例1例，此例属于重度组。结论ICP患者与正常孕妇比较，更易发生羊水粪染、早产、胎儿窘迫、新生儿窒息甚至死胎等不良预后，因此定期产检十分重要，早期发现早期治疗，以达到改善妊娠结局的目的。Objective To explore pregnancy outcomes of 100 cases with intrahepatic cholestasis of pregnancy （ ICP ） . Methods Retrospective analysis was carried out in 100 ICP cases who gave birth in Xiasha Branch of Zhejiang Province Traditional Chinese Medical Hospital during the period from March 2013 to March 2016. According to TBA, DBIL, TBIL, ALT, AST and other indicators, the patients were divided into two groups, mild group （ 58 cases ） and severe group （ 42 cases ） .Healthy pregnant women who gave birth at the same period were randomly selected as control group. The age, the gestational age at birth, the delivery methods, the skin itching, the diagnosis time, the premature delivery, the fetal distress, the neonatal asphyxia, the amniotic fluid, the admission to neonatal intensive care unit （ NICU ） , the death ofperinatal infants and other clinical data of these three groups were analysed. Results The average gestational age of mild group, severe group and control group were （ 37 ± 1.6 ） weeks, （ 35 ±1.8 ） weeks and （ 39 ± 1.2 ） weeks respectively. Cesarean seetion rates were 55.17%, 85.71% and 33%. The amniotie fluid meconium rate were 5.17%, 38.09% and 3%. The difference among the three groups was statistically significant （ P〈0.05 ） .The average diagnosis time of mild group and severe group were （ 31 ± 1.5 ） weeks and （ 29 ± 1.6 ） weeks respectively. The incidences of skin pruritus were 82.76% and 88.10%. Preterm birth rates of mild group, severe group and control group were 39.66%、 69.05% and 10.00% respectively.The incidences of fetal distress were 39.66%、 76.19% and 11.00%. The incidences of newborn suffocation were 5.17%, 45.24% and 3.00%. The rates of admission to neonatal intensive care unit （NICU） were 32.76%、 76.19% and 12.00%. The difference was statistically significant （P〈0.05） .One perinatqal infant died in the severe group. Conclusions Compared with healthy pregnant women, ICP cases have a greater risk for meconium-staining amniotic flu

关 键 词：妊娠期肝内胆汁淤积综合征 围生儿 预后 

分 类 号：R714.255[医药卫生—妇产科学]