28例妊娠期重型病毒性肝炎的临床研究

目的探讨妊娠期重型病毒性肝炎（以下简称妊娠重肝）的病原分型及临床特点。方法回顾性分析28例妊娠重肝患者的临床表现及实验室资料。结果本组病例病原感染率分别为：HAV3．57％，HBV64．29％，HCV7．14％，HDV3．57％，HEV25．00％，重叠感染率为28．57％；病死率为67．86％，妊娠并急性、亚急性及慢性重型肝炎的病死率分别为87．50％、80．00％、53．33％；早孕仅1例，存活；而中孕、晚孕并重型肝炎病死率分别为75．00％、68．42％；存活组和死亡组在凝血酶原时间、血清总胆固醇及肝脏萎缩的比较上有统计学差异（P〈0．05）；肝性脑病、感染、肝肾综合征、DIC、产后大出血发生率分别为78．57％、78．57％、50．00％、35．71％、25．00％；胎儿死亡率46．43％。结论本组妊娠重肝以HBV感染最常见，孕产妇及胎儿死亡率高；妊娠并重型肝炎转归与凝血酶原时间、血清总胆固醇、肝脏体积是否进行性缩小、伴并发症的数量有关．

Study on Severe Viral Hepatitis During Pregnancy

Objective To determine the clinical features of pregnant women with severe viral hepatitis. Methods Clinical and laboratory data from 28 patients were retrospectively analyzed. Results The infection rate for HAV, HBV, HCV, HDV, and HEV was 3.57%, 64.29%, 7.14%, 3.57% and 25.00%, respectively. 28.75% of patients had double infection. The mortality was 67.86%, 87.50%, 80.00%, and 53.33% of the pregnant women had acute, sub-acute, and chronic hepatitis, respectively. 1 infected subject at the first trimester recovered. The mortality rate in women at the second and third trimester was 75.00% and 68.42%, respectively. There was a significant difference in the prothrombin time, total serum cholesterol, and liver necrosis between the patients recovered from the infection and the patients died of the infection. The death rate of the fetus was 46.43%. Conclusion HBV infection is common in patients with severe hepatitis. The mortality of the mothers and the fetus was also high. Prothrombin time, levels of serum cholesterol, and other complications correlate with the severity of hepatitis.