中外医疗
中外醫療
중외의료
CHINA FOREIGN MEDICAL TREATMENT
2015年
20期
68-69
,共2页
妊娠期急性脂肪肝%临床特点%诊治分析
妊娠期急性脂肪肝%臨床特點%診治分析
임신기급성지방간%림상특점%진치분석
Acute fatty liver of pregnancy%Clinical features%Diagnosis and Treatment
目的：探讨妊娠期急性脂肪肝的临床特点、诊疗方法。方法整群选择该院自2012年7月-2015年1月收治的96例妊娠期急性脂肪肝患者的临床资料,全部患者均给予B超、CT等检查,结合实验室检查与病理活检确诊。确诊后,全部患者均给予积极的内科综合治疗,同时,及时终止妊娠。结果该组患者发病前1周,均有不同程度临床症状,全部患者有进行性黄疸加重情况。实验室检查可见细胞数量增加、血小板减少,肝、肾功能、凝血功能异常等症状。给予患者B超检查可见脂肪肝特点,CT可见肝实质均匀一致密度减低。该组患者均给予积极的对症治疗,并于24 h内给予终止妊娠,其中4例患者死亡,其发病时间到妊娠时间大于2周,共娩出胎儿92个,其中男活婴60例,女活婴28例,4例男死婴,围产儿死亡率4.2%。新生儿预后较好。结论加强妊娠晚期患者的临床观察,一旦发现疑似妊娠期急性脂肪肝,应立即给予检查。一经确诊,应立即给予治疗,并终止妊娠,以改善患者与围产儿预后。
目的：探討妊娠期急性脂肪肝的臨床特點、診療方法。方法整群選擇該院自2012年7月-2015年1月收治的96例妊娠期急性脂肪肝患者的臨床資料,全部患者均給予B超、CT等檢查,結閤實驗室檢查與病理活檢確診。確診後,全部患者均給予積極的內科綜閤治療,同時,及時終止妊娠。結果該組患者髮病前1週,均有不同程度臨床癥狀,全部患者有進行性黃疸加重情況。實驗室檢查可見細胞數量增加、血小闆減少,肝、腎功能、凝血功能異常等癥狀。給予患者B超檢查可見脂肪肝特點,CT可見肝實質均勻一緻密度減低。該組患者均給予積極的對癥治療,併于24 h內給予終止妊娠,其中4例患者死亡,其髮病時間到妊娠時間大于2週,共娩齣胎兒92箇,其中男活嬰60例,女活嬰28例,4例男死嬰,圍產兒死亡率4.2%。新生兒預後較好。結論加彊妊娠晚期患者的臨床觀察,一旦髮現疑似妊娠期急性脂肪肝,應立即給予檢查。一經確診,應立即給予治療,併終止妊娠,以改善患者與圍產兒預後。
목적：탐토임신기급성지방간적림상특점、진료방법。방법정군선택해원자2012년7월-2015년1월수치적96례임신기급성지방간환자적림상자료,전부환자균급여B초、CT등검사,결합실험실검사여병리활검학진。학진후,전부환자균급여적겁적내과종합치료,동시,급시종지임신。결과해조환자발병전1주,균유불동정도림상증상,전부환자유진행성황달가중정황。실험실검사가견세포수량증가、혈소판감소,간、신공능、응혈공능이상등증상。급여환자B초검사가견지방간특점,CT가견간실질균균일치밀도감저。해조환자균급여적겁적대증치료,병우24 h내급여종지임신,기중4례환자사망,기발병시간도임신시간대우2주,공면출태인92개,기중남활영60례,녀활영28례,4례남사영,위산인사망솔4.2%。신생인예후교호。결론가강임신만기환자적림상관찰,일단발현의사임신기급성지방간,응립즉급여검사。일경학진,응립즉급여치료,병종지임신,이개선환자여위산인예후。
Objective To observe the clinical features, diagnosis and treatment methods of acute fatty liver of pregnancy. Meth-ods The clinical data of the 96 patients with acute fatty liver of pregnancy admitted in our hospital during July 2012 and January 2015 was selected, all of whom had received b-ultrasonic examination and CT examination and had been confirmed by laboratory tests and pathologic biopsy. Once confirmed, all the patients underwent comprehensive medical treatment positively and timely ter-mination of pregnancy together. Results Clinical symptoms of different levels, such as progressive jaundice exacerbation, were found in all the patients one week before the onset. Other symptoms showed by laboratory tests included the increasing of the number of cells, thrombocytopenia, abnormal liver and kidney function, coagulation disorders and so on. The characteristics of fatty liver can be indicated by b-ultrasonic examination and liver parenchyma density decreasing homogeneously by CT examination. After positive symptomatic treatment and termination of pregnancy within 24 h, there were 4 patients losing their life whose onset had lasted more than 2 weeks, and 92 cases of successful labor with 60 viable male infant and 28 viable female infant, and 4 cas-es of dead infant. The mortality of perinatal infants was 4.2% and neonatal prognosis was good. Conclusion Clinical observation of patients in late pregnancy should be strengthened and inspection should be done for suspected patients with acute fatty liver of pregnancy once found, and treatment and termination of pregnancy should be implemented once diagnosed so as to improve the prognosis of newborn and maternal.
