妊娠期肝内胆汁淤积症不良母婴结局的临床分析(1)
[摘要]目的 探讨妊娠期肝内胆汁淤积症(ICP)对母婴结局的影响。方法 以2008年1月～2015年12月在我院接受救治的65例ICP患者为研究组，根据患者血清总胆汁酸水平将其分为轻度组(43例)与重度组(22例)。选择同期前来我院体检的健康产妇71例为对照组，观察两组患者母婴结局的差异。结果 研究组早产、羊水粪染、剖宫产及产后出血的发生率均明显高于对照组，差异有统计学意义(P<0.05)；研究组胎膜早破发生率与对照组比较，差异无统计学意义(P>0.05)；研究组低体重儿、胎儿窘迫及新生儿窒息的发生率与对照组比较，差异有统计学意义(P<0.05)。重度组早产、羊水粪染、低体重儿、胎儿窘迫、新生儿窒息的发生率均高于轻度组(P<0.05)；两组胎膜早破、剖宫产、产后出血的发生率比较，差异无统计学意义(P>0.05)。结论 妊娠期ICP是导致不良母婴结局的一项重要原因，护理人员应加强对产妇的产前检查以及围生期的胎儿监护护理，对妊娠期肝内胆汁淤积做到早检测、早预防、早治疗。
[关键词]妊娠期肝内胆汁淤积症；总胆汁酸；围生儿；母婴结局
[中图分类号] R714.25 [文献标识码] A [文章编号] 1674-4721(2017)02(b)-0061-03
[Abstract]Objective To explore the effect of intrahepatic cholestasis of pregnancy (ICP) on maternal and neonatal outcomes.Methods 65 patients with ICP from January 2008 to December 2015 treated in our hospital were selected as study group，and they were divided into mild group (43 cases) and severe group (22 cases) according to the level of serum total bile acid；71 healthy parturient from our hospital at the same period were selected as control group.The difference of maternal and infant outcome between two groups were observed.Results Incidence of premature，meconium stained amniotic fluid，cesarean section and postpartum hemorrhage in study group was obvious higher than that in the control group respectively，the difference was statistically significant (P<0.05)；the incidence of premature rupture of membranes in the two groups had no significant difference (P>0.05)；the incidence of low birth weight infants，fetal distress and neonatal asphyxia of the study group was compared with the control group，and the difference was statistically significant (P<0.05).Incidence of premature，meconium stained amniotic fluid，low birth weight infants，fetal distress and neonatal asphyxia in severe group was higher than that in mild group respectively (P<0.05)，the incidence of premature rupture of membranes，cesarean section，and postpartum hemorrhage had no significant difference between two groups (P>0.05).Conclusion Intrahepatic cholestasis of pregnancy is an important cause of adverse maternal and neonatal outcomes，nursing staff should strengthen prenatal care for maternal and perinatal fetal care.Early detection，prevention and treatment should be done for intrahepatic cholestasis of pregnancy.
[Key words]Intrahepatic cholestasis of pregnancy；Total bile acid；Perinatal infant；Maternal and neonatal outcomes
妊娠期肝內胆汁淤积症(intrahepatic cholestasis of pregnancy，ICP)是当前临床较为少见的一种妊娠期疾病类型，其常见于妊娠中、晚期群体而对患儿生命安全造成严重威胁[1]。ICP患者临床上表现出明显的皮肤瘙痒、胆汁酸升高等症状，是造成新生儿突然死亡的一项重要原因[2]。而当前针对ICP患者的发病原因、发病机制等临床上均缺乏清晰统一的研究结论，只能根据临床经验认为ICP患者胎儿死亡的风险与患者病情本身发展的严重程度息息相关[3]。针对ICP患者的临床资料进行全面分析，探讨其对母婴结局的严重威胁，对ICP患者的预防、治疗等均有重要意义[4]。本次研究将对妊娠期ICP对母婴结局的不良影响进行具体探讨，现报道如下。 (潘方利 梁权芳 周银燕)
[关键词]妊娠期肝内胆汁淤积症；总胆汁酸；围生儿；母婴结局
[中图分类号] R714.25 [文献标识码] A [文章编号] 1674-4721(2017)02(b)-0061-03
[Abstract]Objective To explore the effect of intrahepatic cholestasis of pregnancy (ICP) on maternal and neonatal outcomes.Methods 65 patients with ICP from January 2008 to December 2015 treated in our hospital were selected as study group，and they were divided into mild group (43 cases) and severe group (22 cases) according to the level of serum total bile acid；71 healthy parturient from our hospital at the same period were selected as control group.The difference of maternal and infant outcome between two groups were observed.Results Incidence of premature，meconium stained amniotic fluid，cesarean section and postpartum hemorrhage in study group was obvious higher than that in the control group respectively，the difference was statistically significant (P<0.05)；the incidence of premature rupture of membranes in the two groups had no significant difference (P>0.05)；the incidence of low birth weight infants，fetal distress and neonatal asphyxia of the study group was compared with the control group，and the difference was statistically significant (P<0.05).Incidence of premature，meconium stained amniotic fluid，low birth weight infants，fetal distress and neonatal asphyxia in severe group was higher than that in mild group respectively (P<0.05)，the incidence of premature rupture of membranes，cesarean section，and postpartum hemorrhage had no significant difference between two groups (P>0.05).Conclusion Intrahepatic cholestasis of pregnancy is an important cause of adverse maternal and neonatal outcomes，nursing staff should strengthen prenatal care for maternal and perinatal fetal care.Early detection，prevention and treatment should be done for intrahepatic cholestasis of pregnancy.
[Key words]Intrahepatic cholestasis of pregnancy；Total bile acid；Perinatal infant；Maternal and neonatal outcomes
妊娠期肝內胆汁淤积症(intrahepatic cholestasis of pregnancy，ICP)是当前临床较为少见的一种妊娠期疾病类型，其常见于妊娠中、晚期群体而对患儿生命安全造成严重威胁[1]。ICP患者临床上表现出明显的皮肤瘙痒、胆汁酸升高等症状，是造成新生儿突然死亡的一项重要原因[2]。而当前针对ICP患者的发病原因、发病机制等临床上均缺乏清晰统一的研究结论，只能根据临床经验认为ICP患者胎儿死亡的风险与患者病情本身发展的严重程度息息相关[3]。针对ICP患者的临床资料进行全面分析，探讨其对母婴结局的严重威胁，对ICP患者的预防、治疗等均有重要意义[4]。本次研究将对妊娠期ICP对母婴结局的不良影响进行具体探讨，现报道如下。 (潘方利 梁权芳 周银燕)