肝内胆汁淤积症孕妇伴乙型肝炎病毒感染对新生儿及妊娠结局的影响和护理干预

Influence of Intra-hepatic Cholestasis of Pregnant Woman with HBV Infection on Newborn and Pregnancy Outcome and Its Nursing Intervention

目的:分析肝内胆汁淤积症(IC)孕妇伴乙型肝炎病毒(HBV)感染对新生儿和妊娠结局的影响,为临床采取合理的护理干预措施和改善妊娠结局提供参考。方法:选取医院2012年1月—2014年12月间收治的IC伴HBV感染孕妇60例为研究组,同时选取同期医院收治的单纯IC孕妇45例为对照组;采用回顾性分析法,比较两组孕妇妊娠并发症的发生情况和新生儿结局,以及新生儿HBV宫内感染的发生情况。结果:研究组孕妇妊娠并发妊娠高血压症(发生率为23.33%)、早产(发生率为28.33%)和产后出血(发生率为33.33%),均明显高于对照组(P<0.05);研究组孕妇新生儿并发宫内窘迫症(发生率为20.00%)、低体质量儿(发生率为26.67%)和黄疸(发生率为25.00%),均明显高于对照组(P<0.05);研究组孕妇HBV宫内感染率为11.67%高于对照组(P<0.05)。结论:IC孕妇伴HBV感染对孕妇妊娠结局和新生儿有严重影响,因此,采取必要的护理干预措施,加强对IC伴HBV感染孕妇围生期的监护,采取相应的母婴阻断措施,对确保母婴健康具有重要意义。

Objective： To analyze the influence of intrahepatic cholestasis of pregnant woman with HBV infection on pregnancy outcome and newborn, and to provide a reference for taking reasonable interventions and improving pregnancy outcomes. Methods： 105 hospitaled patients from January 2012 to December 2014 were chosen in this study, including 60 pregnant women with IC and HBV-infected and 45 pregnant women with IC only as controls. A retrospective analysis of the outcome of their pregnancy was performed to compare the incidence of pregnancy complications, newborns outcomes and neonatal incidence of HBV intrauterine infection in the two groups. Results： IC and HBV-infected pregnant women were more likely to develop pregnancy-induced hypertension （infection rate was 23.33%） than the IC group, the preterm birth rate （infection rate was 28.33% ） and the incidence of postpartum hemorrhage （infection rate was 33.33%）, newborn intrauterine fetal distress（infection rate was 20%）, low birth weight children （infection rate was 26.67%） and jaundice （infection rate was 25%）were also significantly higher than the IC controls （P〈0.05）. There is no difference in the incidence of HBV intrauterine infection （infection rate： 11.67% ）between the two groups （P〉0.05）. Conclusion ： IC and HBV infection during pregnancy may affect pregnancy outcomes seriously. Therefore, it is neces- sary to take interventional measures such as strengthening the perinatal care ofpregnat women with 1C and HBV-infected, terminating pregnancy timely and taking appropriate measures to PMTCT to ensure maternal and child be healthy.