妊娠期脂肪肝10例临床诊治分析

Clinical analysis of diagnosis and management of acute fatty liver of pregnancy

目的探讨妊娠期急性脂肪肝的临床特点及诊断治疗,以期降低孕产妇及围产儿死亡率。方法对我院2005年到2010年收治的10例妊娠期急性脂肪肝临床资料进行回顾性分析。结果 10例患者经抢救存活9例,死亡1例(10%),其中5例进行了人工肝治疗,围产儿死亡2例(胎死宫内)(15.4%)。90%病例早期有消化道症状:恶心、呕吐、乏力、上腹痛、烦渴,出现黄疸,实验室检查均提示转氨酶升高(ALT<500U/L),胆红素升高,尿酸升高。5例出现多脏器功能衰竭,7例出现凝血功能障碍。结论早期诊断、尽快终止妊娠、积极治疗多脏器功能衰竭是改善母儿预后的关键。

Objective To explore the clinical features and diagnosis and Management of acute fatty liver of pregnancy,so as to reduce the mother and fetus mortality.Methods To retrospective analyze 10 cases of fatty liver of pregnancy from 2005 to 2010 years in our hospital.Results 9 patients survived after emergency treatment in 10 cases and 1 died（10%）,of which 5 cases were artificial liver treatment,2 cases of perinatal death（fetal death）（15.4%）.90% of early cases showed digestive system symptoms：nausea,vomiting,fatigue,upper abdominal pain,thirst,jaundice,all laboratory tests prompted transaminase elevating（ALT500U /L）,bilirubin and uric acid increasing.5 cases of multiple organ failure appeared,7 patients had coagulation disorders.Conclusion Early diagnosis,end the pregnancy timely,active treatment of multiple organ failure is the key to increasing the cure of both mother and fetus.