妊娠期急性脂肪肝14例临床分析

目的 分析妊娠期急性脂肪肝患者的临床表现特征,并追踪妊娠结局,了解疾病的转归。方法 回顾性分析妊娠期急性脂肪肝14例,记录临床资料,包括一般情况如年龄、孕周、是否初产妇等以及临床表现、相关检查、并发症及妊娠结局等。结果 妊娠期急性脂肪肝患者的发病孕周为（34.72±2.51）周,城市人口较多,占78.6%。患者中大部分为初产妇,占92.9%。临床表现以黄疸、血肌酐升高、消化道症状、胆酶分离等为主;并发症则表现为急性肾功能不全的发生率最高,其次为弥散性血管内凝血（DIC）、肝性脑病、产后出血等。妊娠结局：孕母死亡、早产、死胎、新生儿窒息的发生率较高。结论 妊娠期急性脂肪肝好发于妊娠晚期,常伴有严重的并发症,对母胎影响大,在临床工作中应注意及时诊断、治疗。

Clinical analysis of 14 cases with acute fatty liver of pregnancy

Objective To analyze the clinical manifestation feature of patients with acute fatty liver of pregnancy,and track the pregnancy outcome and know the prognosis of the disease. Methods 14 cases with acute fatty liver of preg- nancy were retrospectively analyzed,with clinical data including the general situation （such as age,gestational age, whether primipara, etc）,clinical manifestations,relevant examination,complications and pregnancy outcomes and so on were recorded. Results Pregnancy gestational age at onset in patients with acute fatty liver was （34.72＋2.51） weeks,the urban population was more（accounting for 78.6%）.Most of the patients are primiparas （accounting for 92.9%）.The main clinical manifestations were jaundice,elevated serum creatinine,gastrointestinal symptoms,bile enzyme separation and soo on,and complications are characterized by the highest incidence rate of acute renal insufficiency,followed by dis- seminated intravascular coagulation,hepatic encephalopathy,postpartum hemorrhage,etc.Pregnancy outcomes：the inci- dence rate of motherhood death,premature birth,stillbirth,and neonatal asphyxia were higher. Conclusion Acute fatty liver of pregnancy should be paid attention to timely diagnosis treatment in clinical work,and it appears mostly at late pregnancy often associating with serious complications,and it has a greater impact on mother and the fetus.