妊娠期肝内胆汁淤积症120例分析

A Clinical Analysis of 120 Cases of Intrahepatic Cholestasis of Pregnancy

目的了解妊娠期肝内胆汁淤积症的临床表现和妊娠结局,探讨妊娠期肝内胆汁淤积症对母儿的危害。方法回顾性分析2008年1月-2009年12月期间住院治疗的120例妊娠期肝内胆汁淤积症临床表现、治疗及结局。结果妊娠肝内胆汁淤积症相关危害因素中,首要危害为早产,发生率高达18.3%,其次为胎儿窘迫为10.0%,低体重儿为9.2%,新生儿窒息为6.7%、胎儿生长受限为5.8%,羊水过少为4.2%,产后出血为2.5%等。肝功转氨酶均有不同程度的升高。分娩方式中以剖宫产为主,其中早产剖宫产率高于足月产,以单纯胆淤为首要手术指征,占80.9%。结论妊娠肝内胆汁淤积症可引起早产、胎儿宫内窘迫及新生儿窒息,增高了剖宫产率及产后出血量,对母儿危害较大,但经过积极治疗,预后良好。

Objective To investigate the manifestations of intrahepatic cholestasis of pregnancy（ICP） and the pregnancy outcomes of the patient,and to explore its harmfulness to the fetus and maternity.Methods The data of 120 cases of ICP stayed in our hospital between Jan.2008 and Dec.2009 were analyzed retrospectively.Results The incidence rate of premature labor caused by ICP was the highest（18.3%）,followed by fetal distress（10.0%）,low birth weight infant（9.2%）,apnoea neonatorum（6.7%）,fetus growth limited（5.8%）,oligohydramnios（4.2%） and postpartum hemorrhage（2.5%）.Most of maternity had a varied degree of elevated serum aminotransferase leve1.Majority of pregnant women received cesarean section,especially those in the premature labor group.The simple cholestasis was major operation indication.Conclusion Intrahepatic cholestasis of pregnancy is harmful to the mother and the fetus.It may lead to premature delivery,fetal intrauterine embarrassment and newborns asphyxiation.A good prognosis can be achieved by actively treatment.