妊娠合并重症肝炎29例临床分析

Clinical analysis of 29 cases of pregnancy complicated severe hepatitis

目的 探讨妊娠合并重症肝炎的发病情况与有关围产期正确处理方式,减少对母儿的威胁。方法 对我院近8年来29例妊娠合并重症肝炎的病例进行回顾性分析,通过分析其临床表现、病毒标志物、血生化、B超、病理观察、临床处理与妊娠结局,总结对该病的诊治经验和教训。结果 急性重症肝炎7例(乙型3例、乙丙重叠感染1例、乙戊重叠感染2例、戊型1例),亚急性重症肝炎11例(乙型7例、戊型1例、病毒阴性3例),慢性重症肝炎11例(乙型10例、病毒阴性1例)。孕产妇预后:治愈2例、好转13例、未愈自动出院5例、死亡9例,死亡率为31．0％。死胎1例,死产2例,新生儿死亡4例,新生儿存活率占69．2％,围产儿死亡率为43．8％。结论妊娠合并重症肝炎严重危及母婴生命安全,是产科严重的合并症之一,定期产前教育和检查及早发现和处理是关键。

Objective To investigate the incidence and the proper treatment of severe hepatitis during pregnancy. Methods The clinical menifestation and biochemical examination of 29 cases of severe hepatitis during pregnancy were retrospectively analyzed. Results Among 29 cases of severe hepatitis, 7 cases of acute severe hepatitis, 11 subacute severe hepatitis and 11 chronic severe hepatitis were identified. Totally, 2 cases were fully recovered, 13 improved, 5 demised and 5 left without treatment. Fetal death occurred in 1 cases, 2 were stillbirth, and 1 case was neonatal death. The perinatal mortality rate was 43.8%. Conclusions Severe hepatitis is one of the life-threatening complications during pregnancy. Regular prenatal care and early identification and treatment are crucial to improve the maternal and fetal outcome.