妊娠晚期合并肝功能损害490例病因分布及预后分析

Late pregnancy with 490 cases of liver dysfunction etiology and prognosis of distribution

目的探讨妊娠晚期合并肝功能损害的病因及预后。方法收集490例妊娠晚期合并肝功能损害患者,选取来吉林大学中日联谊医院进行产检的无内科合并症的健康孕妇120例作为对照。对妊娠晚期合并肝功能损害患者的病因分布进行统计,比较妊娠晚期各种合并症对围生儿及产妇的影响。结果妊娠晚期合并肝功能损害的病因主要为病毒性肝炎(58.98%)。妊娠晚期合并病毒性肝炎、妊娠晚期合并ICP患者早产、宫内窘迫发生率、剖宫产、产后大出血发生率均明显高于正常妊娠(P<0.05);妊娠晚期合并病毒性肝炎患者早产、宫内窘迫发生率、剖宫产率均明显低于妊娠晚期合并ICP,而产后大出血发生率高于妊娠晚期合并ICP(P<0.05)。结论病毒性肝炎、ICP、妊娠高血压疾病、HELLP综合征、妊娠急性脂肪肝等均为妊娠晚期合并肝功能损害的主要发病原因,可不同程度地威胁到母婴健康及生命安全,临床上应提高重视程度。

Objective To investigate late pregnancy with hepatic dysfunction etiology and prognosis. Methods A total of 490 cases of pregnancy with advanced hepatic dysfunction were selected, 120 cases of healthy pregnant women choose a regular basis to Sino-Japanese Friendship Hospital of Jilin University for check-in no medical complications of as controls. Etiology of late pregnancy with hepatic impairment distribution statistics,the impact of various complica-tions in late pregnancy on perinatal and maternal child were compared. Results The main causes of late pregnancy with liver dysfunction was viral hepatitis （58.98%）,Late pregnancy with viral hepatitis,late pregnancy with preterm ICP pa-tients,the incidence of fetal distress, cesarean delivery, postpartum hemorrhage was significantly higher than normal incidence of pregnancy（P〈0.05）;late pregnancy with virus preterm hepatitis patients,the incidence of fetal distress,ce-sarean section rate was significantly lower than the ICP,the incidence of postpartum hemorrhage was higher than late pregnancy with ICP （P〈0.05）. Conclusion The main causes of viral hepatitis conclusion,ICP,pregnancy-induced hy-pertension,HELLP syndrome,acute fatty liver of pregnancy,and so are the third trimester with hepatic dysfunction,may threaten to varying degrees of maternal and child health and life safety,clinical should increase the degree of attention.