CAJ | 학술논문

目的探讨妊娠期肝内胆汁淤积症(ICP)的病因、临床特点、治疗方法及母婴预后.方法回顾性分析9例ICP患者临床特点、诊断、治疗及母婴预后情况. 结果 9例患者中,7例患者出现皮肤瘙痒；9例患者胆汁酸升高,1例胆红素升高；3例并发妊娠期高血压,2例分别并发糖尿病、糖耐量异常,1例有先兆子痫；1例羊水胎粪污染；9例患者均行手术分娩,3例早产(35 ～ 36周),母婴预后良好.ICP患者转氨酶、总胆汁酸上升时间多集中在妊娠27 ～ 34周,产后指标开始下降,以总胆汁酸下降速度最为显著,复常时间比转氨酶早. 结论 ICP患者体内胆汁酸升高水平与早产发生率呈正相关,适宜病例可应用熊去氧胆酸治疗,病情较重者应及时引产或行剖腹手术.
목적 탐토임신기간내담즙어적증(ICP)적병인、림상특점、치료방법급모영예후.방법 회고성분석9례ICP환자림상특점、진단、치료급모영예후정황. 결과 9례환자중,7례환자출현피부소양；9례환자담즙산승고,1례담홍소승고；3례병발임신기고혈압,2례분별병발당뇨병、당내량이상,1례유선조자간；1례양수태분오염；9례환자균행수술분면,3례조산(35 ～ 36주),모영예후량호.ICP환자전안매、총담즙산상승시간다집중재임신27 ～ 34주,산후지표개시하강,이총담즙산하강속도최위현저,복상시간비전안매조. 결론 ICP환자체내담즙산승고수평여조산발생솔정정상관,괄의병례가응용웅거양담산치료,병정교중자응급시인산혹행부복수술.
Objective To generate a comprehensive clinical profile of intrahepatic cholestasis of pregnancy (ICP) by systematically reviewing ICP cases managed in our hospital.Methods The recorded clinical data,including diagnosis,complications,management,and maternal and infant outcomes,of nine ICP cases were collected retrospectively and reviewed systematically.Results Seven of the nine total ICP patients presented with pruritus.All nine of the ICP patients showed bile acid level beyond the normal range.ICP complications included gestational hypertension (n =3),diabetes mellitus (DM,n =1) and impaired glucose tolerance (IGT,n =1),and pre-eclampsia (n =1).The infant of one patient with severe ICP showed meconium-stained liquor.All nine of the ICP patients underwent surgical delivery,of which three were delivered preterm (between the 35th and 36th week of gestation).All mothers' total bile acids declined to normal levels after delivery,and all infants survived without complication.Conclusion ICP does not increase the puerpera mortality rate and does not represent a poor prognosis for infants.Bile acid levels in the ICP patients,however,may be related to the extent of premature delivery time.While the standard drug treatment of ursodeoxycholic acid is suitable for most ICP cases,those with insufficient gestational age may benefit from adjuvant corticosteroid therapy to promote fetal lung maturation prior to preterm delivery.Severe ICP cases should be managed by inducing artificial labor or performing Caesarean section.