妊娠期肝内胆汁淤积症妊娠结局56例临床分析

目的探讨妊娠期肝内胆汁淤积症（ICP）孕妇的妊娠结局。方法采用回顾性方法分析常州市第三人民医院自2000年1月～2008年5月56例妊娠期肝内胆汁淤积症患者的妊娠结局（研究组），同期分娩的非妊娠期肝内胆汁淤积症正常孕妇（对照组）．比较两组间患者的妊娠结局情况。结果ICP组患者中总胆汁酸平均值、谷丙转氨酶平均值、谷草转氨酶平均值、总胆红素平均值、直接胆红素的平均值、剖宫产率、产后出血率的值分别为29．7umol／L、135．4U／L、147．3U／L、31．2umol／L、17．33umol／L、78．6％、14．3％，非ICP组患者中胆汁酸平均值、谷丙转氨酶平均值、谷草转氨酶平均值、总胆红素平均值、直接胆红素的平均值、剖产率、产后出血率分别为6．9umol／L、39．4U／L、29．9U／L、10．4umol／L、7．3umol／L、30．3％、3．8％，两组间各值比较差异具有显著性。ICP组患者中围生儿结局（如胎儿宫内窘迫、羊水污染≥Ⅱ度、宫内死胎、新生儿窒息、早产率、低体重儿的发生率分别为37．5％、55．4％、7．14％、21.4％、32．1％、60．7％，非ICP组孕妇中的发生率分别为11．4％、20．5％、0.8％、6.8％、8．3％、15．9％，两组间各值比较差异具有显著性。结论妊娠期肝内胆汁淤积症具有不良的妊娠结局，对母婴危害较大。故应加强母婴监护，重视此类疾病的预防和诊治．改善母婴预后．提高产科质量。

A clinical analysis of pregnancy outcome for 56 cases of ICP

Objective To investigate the pregnancy outcome of interahepatic choloestasis of pregnancy （ICP） in clinic. Methods The clinical data of 56 paturients with ICP in our hospital from January 2000 to March 2008 （study group） and 132 paturients with normal pregnancy in sametime （control gyoup） were observed. The pregnancy outcome were analyzed statistically. Results The score related the pregnant woman of TBA ,ALT, AST, TB , DB, cesarean section, and postpartum hemorrhage in study groups were 29.7± 10.3umol/L, 135.4 ±27.3U/L, 147.3 ± 10.2U/L, 31.2 ±7.6umol/L, 17.3 ±3.1 umol/L, 78.6%, 14.3% respe - ctively. And 6.9±4.3umol/L,39.4±9.9U/L,29.9±13.3U/L, 10.4±3.2umol/L,7.3 ±1.6umol/L,30.3%, 3.8% respectively in control groups. On perinatal infants the incidence rate of fetal distress, fetal distress, amniotic fluid pollutied ≥Ⅱ degree,intrauterine fetal death, neonatal asphyxia premature delivery, lower birth weight in study groups were 37.5%, 55.4%,7.14%, 32.1%,60.7% respectively. And 11.4%, 20.5%, 0.8%,6.8%, 8.3%,15.9% respectively in control groups. Significant statisitical were exist between the pregnancy outcome of this two groups. Conclusion Interahepatic choloestasis of pregnancy （ICP） carries a high risk for adverse pregnancy outcome, harmful to mother and infant. So we should to increase the monitor of prenatal health care and frequence of prenatal examination, pay more attention to the diagnosis and prevention of this kinds of diseases , improve obstetric quality.