摘要
目的探讨双胎合并妊娠期肝内胆汁淤积症(ICP)的诊断、治疗和围生儿预后。方法回顾性分析2004年1月～2009年12月我院收治的57例双胎合并ICP患者的临床资料。结果 27例在36～37周采取剖宫产,母婴均治愈出院。16例30～34周黄染加重,瘙痒症状无明显减轻,总胆汁酸下降不明显,肝酶升高采取剖宫产,其中3例新生儿转儿科治疗,余母婴均治愈出院。9例突然出现胎动消失,急诊采取剖宫产,其中5例新生儿死亡,4例新生儿转儿科治疗。其中2例产时大出血,行输血治疗。5例突然出现胎动消失,胎死宫内,行水囊引产。结论一旦确诊为双胎合并ICP,都必须住院。积极治疗,密切监测母儿情况,适时终止妊娠,尽量确保母婴安全。
Objective To discuss the diagnosis and treatment of Intrahepatic Cholestasis during Pregnancy（ICP） with Twins,and the prognosis of the perinatal children.Methods Retrospective analyzed the clinical imformation of 57 cases from January,2004 to December,2009.Results 27 cases took caesarean section during 36~37 weeks and both the mother and the chidren were heathy.In 16 cases who took caesarean section during 30~34 weeks for deeper icterus,hyper-transaminase,no significant reduction of itching and total biliary acid（TBA）,all the mothers and chidren were heathy except that 3 of the children were transfered to Pediatrics for further treatment.In 9 cases who suddenly lost the fetal movement and took emergent caesarean section,5 children died,4 children were transferred to Pediatrics,2 mothers got blood transfusion for massive haemorrhage.5 cases who suddenly lost the fetal movement and the babies died had induction of labor with water bag.Conclusion So as to make both the mother and children safe,once diagnosed as ICP with Twins,the patient must be hospitalized,taken positive treatments;the mother and children＇ condition must be monitored,and the pregnancy must be stoped at a proper time.
出处
《四川医学》
CAS
2010年第12期1814-1815,共2页
Sichuan Medical Journal
