51例妊娠合并戊型病毒性肝炎的诊断及治疗

Diagnosis and treatment of pregnancy combined with hepatitis E in 51 cases

目的：探讨妊娠合并戊型病毒性肝炎的临床诊断及治疗方法。方法：对上海公共卫生临床中心2008年5月～2013年5月收治的51例妊娠合并戊型病毒性肝炎临床资料进行回顾性分析,并进行统计学处理。结果：①患者多无明显的消化道系统的临床症状;②51例患者中有92.2%转氨酶升高,70.6%血总胆红素升高,45.1%血总胆汁酸升高,39.2%甘胆酸升高,9.8%凝血酶原时间延长;③胎儿窘迫率11.8%,胎膜早破率9.8%,出生低体重率5.9%,胎儿生长受限率、巨大儿、胎盘早剥、羊水过少及死胎率2.0%,肝衰竭发生率为7.8%。结论：早期诊断、积极内科综合支持治疗可有效地预防和治疗并发症,是改善母婴预后的关键。

Objective： To explore the clinical diagnosis and therapeutic method of pregnancy combined with hepatitis E. Meth- ods： The clinical data of 51 pregnant women with E hepatitis E treated in the hospital from May 2008 to May 2013 were analyzed retrospec- tively. Results： The patients had no obvious clinical symptoms of digestive system; among 51 patients, transaminases levels increased in 92. 2% of them, serum total bilirubin levels increased in 70.6% of them, blood total bile acid levels increased in 45. lifo of them, glyco- cholic acid levels increased in 39.2% of them, prothrombin time prolonged in 9.8% of them ; the incidence rates of fetal distress, premature rupture of fetal membrane, low birth weight, fetal growth restriction, macrosomia, placental abruption, oligohydramnios, stillbirth and liver failure were 11.8%, 9. 8%, 5.9%, 2. 0%, 2. 0%, 2. 0%, 2.0%, 2. 0% and 7.8%, respectively. Conclusion： Early diagnosis and positive internal comprehensive support therapy can effectively prevent and treat complications, which is the key to improving maternal and infantile prognosis.