妊娠合并重型肝炎35例临床分析

A Clinical Analysis on Severe Hepatitis with Pregnancy of 35 Cases

目的研究妊娠合并重型肝炎的病因、临床表现以及对胎儿的影响,为该类疾病的预防和治疗提供依据。方法对2004年2月至2011年4月我院收治的35例妊娠合并重型肝炎患者进行了研究,将其作为观察组,以同期35例育龄期但非妊娠期重型肝炎患者作为对照组,分析比较两组患者的临床特征、病原学特征、肝功能以及对妊娠合并重型肝炎对胎儿的影响。结果观察组患者的临床特征,比如死亡、肝性脑病等发生率明显高于对照组,差异有统计学意义(P<0.05);两组患者均以乙型肝炎为主,其次为甲肝和丙肝,差异无统计学意义(P>0.05);在肝功能检测比较中,观察组患者ALT、ALB、PT与对照组差异明显,有统计学意义(P<0.05);观察组患者中,随着妊娠周期的增加,早产和死胎的发生率有明显的升高。结论妊娠合并重型肝炎与非妊娠重型肝炎临床表现明显不同,临床治疗过程中要区别对待,积极治疗与终止妊娠是改善预后的关键,需要给予充分的重视。

Objective Study the reason of severe hepatitis with pregnancy,and the clinical performance,the effects on the fetus,to provide the information for the prevention and treatment of such diseases.Methods 35 pregnant women with severe hepatitis from Feb 2004 to April 2011 in our hospital were studied.They were the observation group,and 35 cases of child-bearing age,but non-pregnant patients with severe hepatitis as a control group,analysis and compared the clinical features,pathogenic characteristics,liver function and severe hepatitis of pregnancy on the fetus between the two groups.Results The clinical characteristics,such as death,hepatic encephalopathy were different bewteen the two groups.the differences were statistically significant（P0.05）;hepatitis B was dominant in the two groups,followed by the hepatitis A and C liver,the difference was not statistically significant（P0.05）;In the liver function tests,the ALT,ALB,PT in the observation group were difference with the control group,which was statistically significant（P 0.05）;In the observation group patients,,the incidence of preterm birth and stillbirth significantly increased with the pregnancy cycle.Conclusion The patients of severe hepatitis with pregnancy had different clinical manifestations with non-pregnant women with severe hepatitis,they were needed to be distinguished in the treatment.positive treatment and termination of pregnancy is critical to improve the prognosis,it should be paid attention in the therapy.