血浆置换法治疗重度妊娠期肝内胆汁淤积症的疗效研究

目的探讨血浆置换法治疗重度妊娠期肝内胆汁淤积症(ICP)的疗效及对围生儿预后的影响。方法选择重度ICP患者35例,依据治疗方法分为两组:A组血浆置换配合药物治疗15例;B组药物治疗20例;疗程均为2周。比较临床症状和肝功能的改善以及围生儿预后。结果治疗前后比较A组患者瘙痒及黄疸症状,肝功能明显改善(P<0.05);B组无明显改善(P>0.05)。与B组相比,A组早产、胎儿窒息、羊水粪染、产后出血发生率明显下降(P<0.05)。结论血浆置换法配合药物治疗是重度ICP安全有效的方法,值得临床推广应用。

Effects of plasma exchange on severe intrahepatic cholestasis in pregnancy

Objective To investigate the therapeutic effect of plasma exchange on severe intrahepatic cholestasis in pregnancy(ICP) and the perinatal prognosis.Methods We enrolled 35 women with severe ICP and divided them into two groups: Group A(n=15) underwent plasma exchange combined with comprehensive medications;Group B(n=20) was treated with comprehensive medicine alone.A two-week course was carried out for each patient.The clinical symptoms and hepatic function pre-and post-treatment of each group were compared,as well as perinatal prognosis.Results Compared with the data of pre-treatment,the symptoms of itch,jaundice and hepatic functions of post-treatment improved significantly in group A(P<0.05),but not in group B(P>0.05).The incidence of preterm birth,fetal distress,meconium-stained amniotic fluid,and postpartum hemorrhage in group A were significantly less than those in group B(P<0.05).Conclusion The plasma exchange combined with comprehensive medications is safety,effective and recommendable in treating severe ICP.