影响妊娠合并重型肝炎预后的单因素研究

目的 分析影响妊娠合并重型肝炎预后的单因素。方法 对66例妊娠合并重型肝炎患者预后的单因素进行回顾性分析。结果 ①不同临床分型的病死率不同,急性型最高,慢性型最低;②Tch、PTA降低、Scr升高及WBC≥10*109/L、"胆酶分离"现象、肝脏缩小均提示病死率升高;③随着肝性脑病、肝肾综合征、出血、感染等并发症的增多,病死率升高, 以上差异均有统计学意义。结论 临床分型、Tch、PTA、Scr、WBC、"胆酶分离"现象、肝脏缩小及并发症等是影响妊娠合并重型肝炎预后的重要因素,动态监测上述指标,积极防治各类并发症是提高临床救治成功率的重要措施。

Single-factor investigation on the prognosis of pregnancy complicating fulminant hepatitis.

Objective: To analyze the single factors which influence the prognosis of patients with pregnancy complicating fulminant hepatitis. Methods: Single factors of the prognosis of 66 patients with pregnancy complicating fulminant hepatitis were analyzed retrospectively. Results: (1) Case fatality rate is different with different types of clinical classification, case fatality rate of acute hepatitis is the highest, and case fatality rate of chornic hepatitis is the lowest; (2) Reduction of Tch and PTA, increase of Scr, WBC≥10*109/L, phenomenon of "bilirubin-transaminase separation", shrink of liver are all suggestions of elevation of case fatality rate; (3) With the increase of complications such as hepatic encephalopathy, hepatorenal syndrome, hemorrhage and infection, the case fatality rate was rising, the differencec of above indexes were all significant. Conclusions: Clincal classification, Tch, PTA, Scr, WBC, phenomenon of "bilirubin-transaminase separation", shrink of liver and complications are all important factors which influence the prognosis of patients with pregnancy complicating fulminant hepatitis, dynamic monitoring of such indexes and energetic preventing and treating complications are important measures to improve the achievement ratio of clinical treatment.