妊娠急性脂肪肝35例临床分析

Clinical analysis of 35 cases of acute fatty liver of pregnancy

目的探讨妊娠急性脂肪肝(acute fatty liver of pregnancy,AFLP)的早期诊断方法和治疗原则。方法回顾性分析了1999年1月至2009年12月在北京地坛医院收治的35例AFLP患者的临床资料,并全部进行了随访。结果 AFLP临床表现以消化道症状、肝损害、凝血功能障碍为主要特征,严重者伴多脏器功能受损。孕产妇及围产儿结局:3例孕产妇死亡,5例围产儿死亡。结论早期诊断和及时终止妊娠,加强支持疗法及综合治疗是关键,可有效地降低母婴死亡率。

Objective To explore the early diagnosis and therapeutic principle of acute fatty liver of pregnancy（AFLP）.Methods Medical records of 35 cases with AFLP who were treated in Beijing Ditan Hospital from January 1999 to December 2009 were analyzed retrospectively.All patients were under follow-up.Results The common symptoms were malaise,nausea,vomit,hepatic lesion and coagulation disorders.Severity patients were with multiple organ dysfunction syndrome（MODS）.There were 3 maternal deaths and 5 perinatal fetus deaths.Conclusion Early diagnosis,progressive management and promptly termination of pregnancy are the key treatment which may decrease the mortality of the mothers and fetuses.