重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2014年
13期
1573-1575,1578
,共4页
胆汁淤积,肝内%妊娠并发症%妊娠结局%危险因素%肾功能%药物控制
膽汁淤積,肝內%妊娠併髮癥%妊娠結跼%危險因素%腎功能%藥物控製
담즙어적,간내%임신병발증%임신결국%위험인소%신공능%약물공제
cholestasis,intrabepatic%pregnancy complications%pregnancy outcome%risk factors%renal function%drug control
目的：探讨妊娠期肝内胆汁淤积症（ICP）的临床特点和发病危险因素，提出相关控制措施。方法选择2009年5月至2013年2月在该院产科门诊建卡的 ICP产妇60例作为观察组，同期选择在该院住院分娩的非 ICP产妇60例作为对照组，两组都同时进行实验室检查和产妇及新生儿的预后调查。观察组给予药物综合治疗。结果所有产妇都顺利分娩出新生儿，无产妇与新生儿死亡。观察组的分娩孕周明显短于对照组，新生儿 Apgar 1 min评分及新生儿体质量明显低于对照组，剖宫产率明显高于对照组（P＜0．05），两组的产后出血、羊水污染、早产、新生儿窒息、住院时间、新生儿5 min评分与对照组相比差异无统计学意义（P＞0．05）。观察组的血尿素氮（BUN）、乳酸脱氢酶（LDH）、血浆凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）的水平高于对照组，差异有统计学意义（P＜0．05）。两组之间三酰甘油（TG）、空腹血糖（GLU）的水平差异无统计学意义（P＞0．05）。血压控制情况、肾损害与产检是影响妊娠期肝内胆汁淤积症的独立危险因素（P＜0．05）。经过治疗后，观察组痊愈42例，显效14例，有效4例，无效0例，显效率为90．0％，有效率为100．0％。结论 ICP对于产妇与新生儿都有一定影响，多伴随有肾功能损害；血压控制情况、肾损害与产检是影响 ICP的独立危险因素，药物综合治疗能取得较好的效果。
目的：探討妊娠期肝內膽汁淤積癥（ICP）的臨床特點和髮病危險因素，提齣相關控製措施。方法選擇2009年5月至2013年2月在該院產科門診建卡的 ICP產婦60例作為觀察組，同期選擇在該院住院分娩的非 ICP產婦60例作為對照組，兩組都同時進行實驗室檢查和產婦及新生兒的預後調查。觀察組給予藥物綜閤治療。結果所有產婦都順利分娩齣新生兒，無產婦與新生兒死亡。觀察組的分娩孕週明顯短于對照組，新生兒 Apgar 1 min評分及新生兒體質量明顯低于對照組，剖宮產率明顯高于對照組（P＜0．05），兩組的產後齣血、羊水汙染、早產、新生兒窒息、住院時間、新生兒5 min評分與對照組相比差異無統計學意義（P＞0．05）。觀察組的血尿素氮（BUN）、乳痠脫氫酶（LDH）、血漿凝血酶原時間（PT）、活化部分凝血活酶時間（APTT）、纖維蛋白原（FIB）的水平高于對照組，差異有統計學意義（P＜0．05）。兩組之間三酰甘油（TG）、空腹血糖（GLU）的水平差異無統計學意義（P＞0．05）。血壓控製情況、腎損害與產檢是影響妊娠期肝內膽汁淤積癥的獨立危險因素（P＜0．05）。經過治療後，觀察組痊愈42例，顯效14例，有效4例，無效0例，顯效率為90．0％，有效率為100．0％。結論 ICP對于產婦與新生兒都有一定影響，多伴隨有腎功能損害；血壓控製情況、腎損害與產檢是影響 ICP的獨立危險因素，藥物綜閤治療能取得較好的效果。
목적：탐토임신기간내담즙어적증（ICP）적림상특점화발병위험인소，제출상관공제조시。방법선택2009년5월지2013년2월재해원산과문진건잡적 ICP산부60례작위관찰조，동기선택재해원주원분면적비 ICP산부60례작위대조조，량조도동시진행실험실검사화산부급신생인적예후조사。관찰조급여약물종합치료。결과소유산부도순리분면출신생인，무산부여신생인사망。관찰조적분면잉주명현단우대조조，신생인 Apgar 1 min평분급신생인체질량명현저우대조조，부궁산솔명현고우대조조（P＜0．05），량조적산후출혈、양수오염、조산、신생인질식、주원시간、신생인5 min평분여대조조상비차이무통계학의의（P＞0．05）。관찰조적혈뇨소담（BUN）、유산탈경매（LDH）、혈장응혈매원시간（PT）、활화부분응혈활매시간（APTT）、섬유단백원（FIB）적수평고우대조조，차이유통계학의의（P＜0．05）。량조지간삼선감유（TG）、공복혈당（GLU）적수평차이무통계학의의（P＞0．05）。혈압공제정황、신손해여산검시영향임신기간내담즙어적증적독립위험인소（P＜0．05）。경과치료후，관찰조전유42례，현효14례，유효4례，무효0례，현효솔위90．0％，유효솔위100．0％。결론 ICP대우산부여신생인도유일정영향，다반수유신공능손해；혈압공제정황、신손해여산검시영향 ICP적독립위험인소，약물종합치료능취득교호적효과。
Objective To investigate the clinical characteristics and risk factors for intrahepatic cholestasis of pregnancy(ICP), and put forward relevant control measures.Methods May 2009 to February 2013 in our hospital maternity clinic built card ICP 60 cases of pregnant women as the observation group,choosed the same period in our hospital 60 cases of childbirth without ICP as the control group,two groups have carried out surveys of maternal and neonatal outcomes,and laboratory tests.While observing the pa-tients were given drug therapy.Results All mothers were smooth delivery of the newborn,no maternal and neonatal mortality.Pro-duction of the observation group was significantly shorter than the control group gestational age,neonatal apgar 1 minute(s)and birth weight was significantly lower,cesarean section rate was significantly higher(P<0.05),two groups of postpartum hemor-rhage,amniotic fluid abnormalities,prematurity,neonatal asphyxia,hospitalization time,neonatal apgar 5 minute(s)compared with the control group had no significant difference(P> 0.05).Observation group BUN,LDH,PT,APTT,FIB levels higher,the differ-ence was statistically significant(P<0.05).Between the two groups TG,GLU levels had no significant difference(P> 0.05).blood pressure control and kidney damage and prenatal affecting intrahepatic cholestasis of pregnancy independent risk factor for the inci-dence(P<0.05).After treatment,the observation group 42 cases were cured,14 cases markedly effective,4 cases ecfectiveness and no case failure.markedly effective rate was 93.3%,the effective rate was 100.0%.Conclusion ICP for maternal and newborn have a certain influence,many accompanied by renal dysfunction,blood pressure control and kidney damage and check-ups during preg-nancy that affect the incidence of ICP independent risk factors,drug therapy can achieve better results.
