妊娠期肝内胆汁淤积症患者与正常孕产妇的临床对照研究

目的探讨妊娠期肝内胆汁淤积症对孕妇妊娠及围生儿结局的影响。方法选择我院2009年9月。2010年10月收治的妊娠期肝内胆汁淤积症患者73例作为观察组，选择同期健康孕妇70例作为对照组，比较两组孕妇妊娠及围生儿结局。结果观察组的早产、剖宫产率分别为12．3％、16．4％，均明显高于对照组的1．4％、4．3％，且观察组产后出血量明显多于对照组，组间差异均有统计学意义（P〈0．05）；两组胎儿前置胎盘和脐带绕颈发生率间差异无统计学意义（P〉0．05），而观察组羊水粪染发生率为15．1％，明显高于对照组的2．9％，组间差异有统计学意义（P〈0．05）；观察组新生儿窒息、低体重儿的发生率分别为11．0％、19．2％，均明显高于对照组的1．4％、2．9％，且观察组新生儿Apgar评分明显低于对照组，组间差异均有统计学意义（P〈0．05）。结论妊娠期肝内胆汁淤积症对孕妇妊娠及围生儿结局均有不良影响，临床应尽早发现并积极治疗，争取获得更好的母婴结局。

Clinical Control Study on Intrahepatic Cholestasis of Pregnancy and Normal Pregnancy Women

Objective To observe the influence of intrahepatic cholestasis of pregnancy on outcome of pregnant women and perinatals. Methods From September 2009 to October 2010 in our hospital, 73 cases of pregnant women with intrahepatic cholestasis were selected as the observation group, and 70 cases of healthy pregnant women during the same period as the control group. The outcome of pregnant women and perinatals of two groups were observed. Results In observation group, the premature birth rate and cesarean section rate were 12.3% and 16.4%, significantly higher than 1.4% and 4.3% of the control group, and the postpartum hemorrhage of the observation group was significantly more than the control group, the differences were statistically significant between two groups （ P 〈 0.05 ） ; The incidence of placenta previa and cord around neck of two groups had no significant difference （ P ~ 0.05 ）, but the incidence of meconium-stained amniotic fluid of observation group was 15.1%, significantly higher than 2.9% of the control group and the difference was statistically significant between two groups （P 〈 0.05 ） ; In observation group, the incidence of neonatal asphyxia and low birth weight children were 11.0% and 19.2%, were significantly higher than 1.4% and 2.9% of the control group, and the Apgar scores of observation group were significantly lower than the control group, the differences were statistically significant between two groups （P 〈 0.05 ）. Conclusion Intrahepatic cholestasis of pregnancy has adverse effects on outcome of pregnant women and perinatals ; Clinical early detection and aggressive treatment should be carried out to strive for better maternal and neonatal outcomes.