妊娠急性脂肪肝剖宫产术患者临床护理体会

Nursing care for caesarean section in patients with acute fatty liver of pregnancy

目的探讨妊娠急性脂肪肝剖宫产术患者围手术期护理特点。方法选择1996年1月至2012年1月本院行剖宫产手术的AFLP患者剖宫产手术围手术期护理经验进行总结。结果共计19例患者纳入研究,平均年龄(27.9±3.5)岁,其中初产妇14例(73.7%)前驱症状为乏力、纳差、恶心、呕吐、黄疸。实验室检查示肝功能异常、凝血功能障碍、白细胞升高、肾功能损伤等。入院后密切进行胎儿监测、对围手术期孕产妇进行心理干预,在术后密切注意产后出血的观察和护理,同时加强产后护理,预防感染等护理措施干预后,产妇死亡2例(10.5%),无围产儿死亡。结论对妊娠急性脂肪肝围手术期患者采取综合护理措施,对于改善预后起到积极的帮助。

Objective To discuss the nursing care methods for emergency caesarean section in patients with acute fatty liver of pregnancy. Methods Retrospective analysis of clinical characteristics and nursing care of patients with AFLP was receiving cesarean section in our hospital from January 1996 to January 2012. Results Nineteen cases were involved in this research who aged（27.9 ± 3.5） years old. Primipara accounted for 73.7%. Symptoms include malaise, nausea, vomiting and jaundice. Laboratory results indicated liver function abnormalities, coagulopathy, hypoglycemia and acute renal injury. After admission, we gave fetal monitoring closely, mental intervention, watching closely postoperative especially for postpartum hemorrhage and infection prophylaxis, there were two maternal deaths（10.5%）, but no fetal deaths. Conclusions AFLP is a rare but life-threatening complication in late pregnancy. General nursing care methods would be helpful for the management of emergency caesarean section in patients with acute fatty liver of pregnancy.