妊娠期肝内胆汁淤积症的早期干预与妊娠结局

目的:探讨妊娠期肝内胆汁淤积症(ICP)的早期干预对妊娠结局的影响。方法:分析比较74例ICP患者干预治疗前后,与同期未做过任何干预的51例ICP患者的肝功能指标及围生儿结局进行比较。结果:观察组治疗后血清胆汁酸、总胆红素、直接胆红素、谷丙转氨酶、谷草转氨酶等生化指标较治疗前明显下降(P<0.01)。与对照组比较观察组孕周延长,新生儿体重增加,胎儿窘迫、羊水粪染、早产及新生儿窒息发生率较低(P<0.01)。但围生儿病死率无明显改变,两者比较无显著差异(P>0.05)。结论:积极正确处理妊娠期肝内胆汁淤积症可明显降低围生儿的胎儿窘迫、羊水粪染、新生儿窒息等的发生率,提高围生儿的生存质量。

Early intervention of intrahepatic cholestasis of pregnancy and the perinatal outcomes

Objective：To investigate the outcomes of early intervention on the pregnancy with intrahepatic cholestasis （ICP）.Methods：The liver function and perinatal outcomes were observed and compared between the 74 pregnant women with ICP before and after early intervention（observational subjects） and 51 cases of ICP without any intervention（controls）.Results：By antenatal treatment,the biochemical parameters were down-regulated significantly regarding TBA,TBIL,DBIL,GPT and GOT for the observational subjects,with gestational weeks prolonged,weight gain of the newborns,reduced incidence of fetal distress,meconium-stained amniotic fluid,preterm delivery and neonatal asphyxia as compared with the controls（P0.01）.Yet,the incidence of perinatal death had no statistical difference between the two groups（P0.05）.Conclusion：Intensive care and proper treatment may reduce the perinatal incidence of fetal distress,meconium passage and neonatal asphyxia,but can improve the life quality of the neonates born to ICP pregnant women.