摘要
目的:探讨妊娠期急性肝衰竭(ALF)患者预后的影响因素。方法:回顾性分析2014年1月-2022年6月在新余市妇幼保健院妇保科接受治疗的80例妊娠期ALF患者的临床资料,按患者病情转归将其分为好转组与恶化组。比较两组年龄、孕周、产次情况、并发症数量、病因、临床生化指标、ALF相关评分、治疗方法;分析影响ALF患者预后的因素。结果:两组并发症数量比较,差异有统计学意义(P<0.05)。好转组总胆红素(TBIL)、血肌酐(Scr)、国际标准化比值(INR)、终末期肝病评估模式(MELD)评分均低于恶化组,人工肝治疗患者占比高于恶化组(P<0.05)。经logistic回归分析,TBIL、Scr、并发症数量≥4种、MELD评分是妊娠期ALF患者预后不良的危险因素(P<0.05)。结论:TBIL与Scr水平异常升高、并发症数量≥4种、MELD评分是妊娠期ALF患者预后不良的危险因素,可能增加病情恶化风险,临床应予以高度重视。
Objective:To investigate the prognosis influencing factors of patients with acute liver failure(ALF)during pregnancy.Method:The clinical data of 80 patients with ALF during pregnancy who received treatment in the Department of Obstetrics and Gynecology of Xinyu Maternal and Child Health Hospital from January 2014 to June 2022 were retrospectively analyzed,and the patients were divided into remission group and deterioration group according to their disease outcomes.Age,gestational age,birth times,number of complications,etiology,clinical biochemical indexes,ALF scores and treatment methods were compared between the two groups;the factors affecting the prognosis of ALF patients were analyzed.Result:There was significant difference in the number of complications between the two groups(P<0.05).Total bilirubin(TBIL),blood creatinine(Scr),international normalized ratio(INR)and mode of evaluation of end-stage liver disease(MELD)scores in remission group were lower than those in deterioration group,and the proportion of patients treated with artificial liver was higher than in the deterioration group(P<0.05).By logistic regression analysis,TBIL,Scr,number of complications≥4,and MELD score were risk factors for poor prognosis in patients with ALF during pregnancy(P<0.05).Conclusion:Abnormally elevated levels of TBIL and Scr,number of complications≥4,and MELD score are risk factors for poor prognosis in patients with ALF in pregnancy,which may increase the risk of deterioration and should be given high clinical priority.
作者
吴水莲
WU Shuilian(Xinyu Maternal and Child Health Hospital,Jiangxi Province,Xinyu 338000,China)
出处
《中国医学创新》
CAS
2023年第15期145-149,共5页
Medical Innovation of China
关键词
急性肝衰竭
妊娠期并发症
临床结局
生化指标
Acute liver failure
Complications in pregnancy
Clinical outcome
Biochemical indicators
