妊娠急性脂肪肝的肝穿价值分析

报告7例妊娠急性脂肪肝9次肝穿刺及病理学检查结果,肝穿刺后均无活动性出血、发热等并发症,进一步明确了诊断,探讨了肝穿刺在妊娠急性脂肪肝诊断中的应用价值。     

妊娠合并急性轻型胰腺炎6例临床分析

分析６例妊娠合并急性轻型胰腺炎的诊断与治疗资料认为：（１）其病因可能是综合因素。（２）血、尿淀粉酶的动态观察结合片象变化是监测病情变化的有效手段。（３）妊娠合并急性轻型为不是剖宫产术指征。应以保守治疗为主。     

Acute fatty liver of pregnancy: diagnosis and management of 8 cases

Objective To investigate the early recognition and management of acute fatty liver of pregnancy (AFLP) to improve maternal and fetal survival.Methods Eight cases of AFLP seen in our hospital during the past three years were studied retrospectively. Symptoms, laboratory findings, timing of liver biopsy, and maternal and fetus outcome were assessed.Results The mean gestational age at onset was 34±2 weeks. All cases were primigravida. In the early stages, all patients presented malaise, nausea, vomiting and epigastric distress followed by jaundice in the third trimester of pregnancy. Laboratory findings: all had raised transaminases and serum bilirubin (32.5-510.8 μmol/L), hypoalbuminemia (22.4-30.0 g/L), hypofibrinogenemia (<180 mg/dl), prolonged prothrombin time and prolonged partial thromboplastin time. Maternal complication included hepatic encephalopathy (6 cases), ascites (6), hypoglycemia (5), hematemesis (2), and postpartum hemorrhage (5) and preeclampsia (4). Emergency cesarean section was performed in 3 cases. One mother died of fulminant hepatic failure and the others survived. There was no fetus death. Liver biopsy was done on the 5th to 15th postpartum day in 8 cases. Conclusion With increasing awareness, especially in the early recognition of milder cases, and prompt progressive management including early termination of pregnancy by cesarean section and large dose infusion of fresh frozen plasma and albumin alternately, the prognosis of AFLP can be improved.     

妊娠急性脂肪肝的肝穿价值分析

报告７例妊娠急性脂肪次肝穿刺及病理学检查结果,肝穿刺后均无活力性出血、发热并发症,进一步明确了诊断,探讨了肝穿刺在妊娠急性脂肪肝诊断中的应用价值。     

妊娠合并急性轻型胰腺炎6例临床分析

分析6例妊娠合并急性轻型胰腺炎的诊断与治疗资料认为：①其病因可能是综合因素。②血、尿淀粉酶的动态观察结合临床征象变化是监测病情变化的有效手段。③娠娠合并急性轻型胰腺炎不是剖宫产术指征。应以保守治疗为主。     

微波治疗女阴尖锐湿疣76例疗效观察

采用微电脑控制多功能微波手术器治疗女性外阴部尖脱疣７６例，治愈率为９７．４％，无明显并发症。     

外阴恶性黑色素瘤的治疗特点与预后关系--附18例临床分析

外阴恶性黑色素瘤 (vulvarmalignantmelanoma ,以下简称外阴恶黑 )是一少见的妇科恶性肿瘤 ,恶性度极高。笔者收集了1979年 1月 -1995年 12月 ,就诊于苏州大学附属第一医院妇产科和江苏省南通市肿瘤医院妇瘤科的 18例原发性外阴恶性黑色素瘤 ,全部经病理证实及随访。现对其临床表现、治疗情况及预后进行回顾性分析。1　临床资料1.1　一般资料18例患者就诊时年龄为 2 3～ 73岁 ,平均年龄 5 4 44± 6 63岁。其中 40岁以上 16例 ,占 88 89%。除 1例以外阴色素改变为主诉就诊外 ,17例以外阴肿块或结节为主诉就诊。伴外阴瘙痒 3例 ,破溃出血 3例 …     

微波治疗女阴尖锐湿疣76例疗效观察

采用微电脑控制多功能微波手术器治疗女性外阴部尖脱湿疣76例，治愈率为97．4％，无明显并发症。     

妊娠期急性脂肪肝20例临床分析

目的:探讨妊娠期急性脂肪肝(AFLP)的临床特点、诊治及母儿预后.方法:回顾性分析我院近十年中出院诊断为AFLP的20例患者的临床经过、实验室检查和治疗.结果:母亲平均年龄24 4-3.7岁(20～35岁),平均发病孕周34.80±2.88周(28～40+2周),平均分娩孕周36.45±2.58周(30～40+2周).全部患者的诊断根据临床症状和实验室检查,其中4例经肝穿刺活检证实.母亲并发症:肝性脑病9例、肝肾综合征11例、腹水18例、低血糖7例、产后出血9例.20例患者均接受大量血浆及白蛋白交替治疗,其中10例另接受血浆置换,并发急性呼吸窘迫综合征5例、腹腔置管7例.母亲死亡率25%(5/20),围生儿死亡率为23%(5/22).结论:重视孕晚期孕妇出现恶心、呕吐、乏力等症状,及早进行肝肾功能和DIC检查;尽量早期确诊,及时终止妊娠,多科室合作的综合支持治疗,避免过度液体复苏,母亲预后可望改善.