8例妊娠期急性脂肪肝的诊治分析

Early Diagnosis of Acute Fatty Liver during Pregnancy

目的对妊娠期急性脂肪肝进行早期诊断和正确治疗,以降低孕产妇及围产儿的死亡率。方法对1995-2005年在我院产科经治的8例妊娠期急性脂肪肝患者的资料进行回顾性分析。结果8例患者中,单胎6例,双胎2例。3例孕产妇死亡,均为非及时终止妊娠者。其中阴道分娩1例,剖宫产2例,病死率为37.50%;围产儿死亡4例,死亡率为40.00%。分娩后的临床表现及化验结果均较产前明显恶化,以3d内最严重,但与分娩方式无关。结论早期诊断、及时终止妊娠及多学科的综合治疗,可大大改善妊娠期急性脂肪肝的母儿预后。

Objective To increase the awareness of the early diagnosis of acute fatty liver of pregnancy （AFLP）and to reduce the mortality of the mother and the fetus. Method Retrospective analysis on 8 patients with AFLP was performed between 1 Dec. 1995 and 31 Dec. 2005 in our hospital. Result Two out of 8 cases were twin pregnancy. The mortality for the mothers was 37.5%（3 cases）and the mortality for the fetuses was 40% （4 cases）. Conclusion Early diagnosis, early termination of pregnancy and effective management of pregnancy will improve the prognosis of AFLP.