妊娠期肝内胆汁淤积症不良母婴结局临床探析.doc

妊娠期肝内胆汁淤积症不良母婴结局临床探析 　　[摘要]目的 探讨妊娠期肝内胆汁淤积症（ICP）对母婴结局的影响。方法 以2008年1月～2015年12月在我院接受救治的65例ICP患者为研究组，根据患者血清总胆汁酸水平将其分为轻度组（43例）与重度组（22例）。选择同期前来我院体检的健康产妇71例为对照组，观察两组患者母婴结局的差异。结果 研究组早产、羊水粪染、剖宫产及产后出血的发生率均明显高于对照组，差异有统计学意义（P0.05）；研究组低体重儿、胎儿窘迫及新生儿窒息的发生率与对照组比较，差异有统计学意义（P0.05）。结论 妊娠期ICP是导致不良母婴结局的一项重要原因，护理人员应加强对产妇的产前检查以及围生期的胎儿监护护理，对妊娠期肝内胆汁淤积做到早检测、早预防、早治疗 [关键词]妊娠期肝内胆汁淤积症；总胆汁酸；围生儿；母婴结局 [中图分类号] R714.25 [文献标识码] A [文章编号] 1674-4721（2017）02（b）-0061-03 [Abstract]Objective To explore the effect of intrahepatic cholestasis of pregnancy （ICP） on maternal and neonatal outcomes.Methods 65 patients with ICP from January 2008 to December 2015 treated in our hospital were selected as study group，and they were divided into mild group （43 cases） and severe group （22 cases） according to the level of serum total bile acid；71 healthy parturient from our hospital at the same period were selected as control group.The difference of maternal and infant outcome between two groups were observed.Results Incidence of premature，meconium stained amniotic fluid，cesarean section and postpartum hemorrhage in study group was obvious higher than that in the control group respectively，the difference was statistically significant （P0.05）；the incidence of low birth weight infants，fetal distress and neonatal asphyxia of the study group was compared with the control group，and the difference was statistically significant （P0.05）.Conclusion Intrahepatic cholestasis of pregnancy is an important cause of adverse maternal and neonatal outcomes，nursing staff should strengthen prenatal care for maternal and perinatal fetal care.Early detection，prevention and treatment should be done for intrahepatic cholestasis of pregnancy. [Key words]Intrahepatic cholestasis of pregnancy；Total bile acid；Perinatal infant；Maternal and neonatal outcomes 妊娠期肝?鹊ㄖ?淤积症（intrahepatic cholestasis of pregnancy，ICP）是当前临床较为少见的一种妊娠期疾病类型，其常见于妊娠中、晚期群体而对患儿生命安全造成严重威胁[1]。ICP患者临床上表现出明显的皮肤瘙痒、胆汁酸升高等症状，是造成新生儿突然死亡的一项重要原因[2]。而当前针对ICP患者的发病原因、发病机制等临床上均缺乏清