摘要
目的：探讨妊娠合并重型肝炎产前内科保守治疗的效果。方法：回顾性分析我院1998—2007年40例妊娠合并重型肝炎患者的相关资料，对比入院时及分娩前的MELD值、凝血酶原活动度、血清总胆红素、血清总胆固醇、血清肌酐、血清胆碱酯酶、血清白蛋白的变化，肝肾综合征、肝性脑病、心衰、肺水肿、感染等并发症的发生情况，以及临产或先兆临产、胎儿窘迫、胎盘早剥、死胎等产科情况。统计学方法采用配对资料的t检验、卡方检验和等级资料的秩和检验。结果：仅1例患者于孕期治愈出院至孕足月分娩；余39例均于入院后10天内分娩，分娩前MELD值、血清总胆红素、血清肌酐、凝血酶原活动度高于入院时，血清总胆固醇、血清胆碱酯酶、血清白蛋白低于入院时，分娩前肝肾综合征、肝性脑病、心衰、肺水肿、感染、临产、胎儿窘迫、胎盘早剥、死胎等的发生率高于入院时，差异有显著性。结论：多数妊娠合并重型肝炎产前行内科保守治疗效果不好，易发生内科、产科并发症，应积极治疗后选择适当时机终止妊娠。
Objective： To explore the effect of medical therapy of hepatitis gravis in pregnancy before delivery. Methods： From 1998 to 2007, 40 cases of hepatitis gravis in pregnancy wereretrespected, the changes of MELD value, plasma thromboplastin activity, serum total bilirubin, cholesterol, creatine, cholinesterase and albumin, the incidence of complications such as hepato - renal syndrome, hepat- ic encephalopathy, heart failure, lung edema, infection, the incidence of obstetric complications such as labor or threatened labor, fetal dis- tress, abruption plancentae, fetal death were compared at admission and before delivery using t test, ehi - sqare test and rank sum test. Results： Only 1 case was cured before delivery, the rest 39 cases gave birth in 10 days after admission, MELD value, plasma thrombo- plastin activity, serum total bilirubin, creatine before delivery were higher than at admission, serum cholesterol, cholinesterase, albumin be- fore delivery were lower and the incidence of hepato- renal syndrome, hepatic encephalopathy, heart failure, lung edema, infection, labor or threatened labor, fetal distress, placental abruption, fetal death before delivery were significantly higher. Conclusion： For most eases of hepatitis gravis in pregnancy, the effect of medical therapy before delivery is unsatisfactory, the medical and obstetric complications are prone to take place, optimum opportunity should be chosen to terminate pregnancy after aborative treatment.
出处
《中国妇幼保健》
CAS
北大核心
2008年第27期3813-3815,共3页
Maternal and Child Health Care of China
基金
广东省科技计划项目基金资助(编号:2005B340201006)
广东省中医药局科技基金资助(编号:1060166)
关键词
妊娠
重型肝炎
内科治疗
Pregnancy
Hepatitis gravis
Medical therapy
