肝炎肝衰竭和妊娠急性脂肪肝肝衰竭的母婴结局分析  

Mother-fetus outcome of hepatic failure due to hepatitis and hepatic failure due to gestational acute fatty liver

作　　者：金健[1] 谢军艳 JIN Jian;XIE Junyan(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Henan Science and Technology University,Luoyang,Henan 471000,China)

机构地区：[1]河南科技大学第一附属医院妇产科,河南洛阳471000

出　　处：《中国医学工程》2020年第10期49-51,共3页China Medical Engineering

摘　　要：目的分析肝炎肝衰竭和妊娠急性脂肪肝(AFLP)肝衰竭的母婴结局。方法回顾性分析河南科技大学第一附属医院2017年1月至2019年1月收治的13例妊娠期肝衰竭患者病例资料,依据病因不同分为两组,其中AFLP组6例,妊娠期乙型肝炎病毒组(HBV)组7例。两组患者入院后均接受病原学相关检查,并收集所有患者实验室相关指标,分析两组母婴结局。结果两组天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、直接胆红素(DBil)、总胆红素(TBil)水平比较,差异无统计学意义(P>0.05);相较AFLP组,HBV组患者尿酸(UA)、肌酐(Cr)、尿素氮(BUN)水平较低(P<0.05);两组患者均终止妊娠、孕妇存活率比较,差异无统计学意义(P>0.05)。结论UA、Cr、BUN水平可作为妊娠期肝炎肝衰竭与急性脂肪肝肝衰竭区分依据,且对于肝衰竭的病因需尽早明确,结合孕妇实际情况选择合适的时机尽早终止妊娠,以改善母体结局。【Objective】To analyze the mother-fetus outcome of the hepatitis and hepatic failure and gestational acute fatty liver and hepatic failure.【Methods】The medical data of 13 patients with gestational hepatic failure in the hospital from January 2017 to January 2019 were retrospectively analyzed.All selected cases were divided into 6 cases of acute fatty liver of pregnancy(AFLP)group and 7 cases of gestational hepatitis B virus(HBV)group according to different causes of disease.Two groups received etiological examination after admission,and the laboratory related indexes of all patients were collected.The mother-fetus outcome of two groups was analyzed.【Results】There was no statistical difference in the levels of AST,ALT,DBil and TBil between two groups(P>0.05).Compared with AFLP group,the UA,Cr and BUN in HBV group were lower(P<0.05).There was no statistical difference in the rate of termination of pregnancy and maternal survival rate between two groups(P>0.05).【Conclusion】UA,Cr,BUN can be used as the basis for distinguishing the gestational hepatitis and hepatic failure and the acute fatty liver and hepatic failure.The cause of hepatic failure needs to be identified as soon as possible,and the appropriate timing should be selected to terminate the pregnancy according to the actual situations of the pregnant woman,so as to improve the mother-fetus outcome.

关 键 词：肝功能衰竭 肝炎 脂肪肝 妊娠 母婴结局 

分 类 号：R575.3[医药卫生—消化系统]