妊娠急性脂肪肝的早期诊断方法和治疗

Early Diagnostic Methods and Treatment of Acute Fatty Liver of Pregnancy

目的：探讨妊娠急性脂肪肝早期诊断方法和治疗。方法选取我院2011年12月～2012年12月接收的4例妊娠期急性脂肪肝患者为观察对象，对临床资料进行回顾性分析。结果患者临床表现有：恶心、呕吐、浑身无力、厌食和黄疸等；经实验室检查患者有肝功能异常、门冬氨酸氨基转移酶及丙氨酸氨基转移酶都有轻度或者中度的表现，胆红素和直接胆红素升高，白蛋白降低，患者肾功能异常，肌酐和尿素氨升高，患者的凝血酶原时间延长，血小板减少。4例患者中1例死亡，新生儿全部成活。结论及早诊断并及时终止妊娠，给予患者支持疗法是治疗妊娠急性脂肪肝的关键，能够降低孕妇及新生儿的死亡率。

Objective To explore the diagnosis and treatment for acute fatty liver in an early stage during pregnancy. Method 4 patients with acute fatty liver during pregnancy received in our hospital from December 2011 to December 2012 were selected as observation objectives with retrospective analysis on clinical materials. Result Clinical manifestations of the patients were nausea, sickness, weakness, anorexia, icterus and so on. Patients were tested with abnormal liver functions, high bilirubin and direct bilirubin, low albumin, abnormal renal function, high creatinine and urea ammonia, longer prothrombin, and less blood platelet. Among the four patients, one died but all newborns survived. Conclusion Supportive therapy is the key to treat acute fatty liver during pregnancy with earlier diagnosis as well as timely termination of pregnancy, which can reduce the mortality rate of pregnant as well as newborns.