妊娠期肝内胆汁郁积症合并妊娠期糖尿病诊治分析

发布时间：2018-03-15 05:28

本文选题：胆汁淤积　切入点：肝内　出处：《中国全科医学》2017年S2期 　论文类型：期刊论文

【摘要】：目的探讨妊娠期肝内胆汁淤积症(ICP)合并妊娠期糖尿病(GDM)的围生期母儿结局。方法选取2010年1月—2015年1月中国人民解放军第451医院住院分娩ICP合并GDM者16例(研究组),单纯ICP 105例(对照组),分别观察两组并发症及分娩情况、围生儿结局。结果研究组妊娠期高血压疾病(PHI)、重度ICP发生率分别为12.5%(2/16)和25.0%(4/16),高于对照组的1.0%(1/105)和4.8%(5/105),差异有统计学意义(P=0.046和0.018)。研究组平均分娩时孕周为36.6周,对照组为36.7周,差异无统计学意义(P=0.545)。研究组早产发生率为25.0%(4/16),高于对照组的3.8%(4/105),差异有统计学意义(P=0.001)。两组剖宫产率分别为87.5%(14/16)和85.7%(90/105),差异无统计学意义(P=0.848)。两组羊水粪染、胎膜早破、胎儿窘迫、胎儿畸形、新生儿窒息、围生儿死亡、巨大儿、低出生体质量儿发生率比较,差异无统计学意义(P0.05);研究组新生儿低血糖发生率高于对照组,差异有统计学意义(P0.05)。研究组新生儿1 min Apgar评分为8.25分,低于对照组的8.87分,差异有统计学意义(P=0.02)。结论 ICP合并GDM使围生期母儿患病率增加,临床应严密监护、个体化治疗,适时终止妊娠,可降低围生期母儿患病率。
[Abstract]:Objective to investigate the perinatal maternal and fetal outcomes of intrahepatic cholestasis of pregnancy (ICP) combined with diabetes mellitus of pregnancy (GDM). Methods 16 cases of ICP with GDM in the 451st Hospital of Chinese people's Liberation Army from January 2010 to January 2015 were selected. Group A, simple ICP, 105 cases (control group, observation of complications and delivery, respectively), Results the perinatal outcome. The incidence of severe ICP in the study group was 12.5% and 25.0% / 16 respectively, which was higher than that in the control group (1.0% / 105) and 4.88% / 105 (P 0.046 and 0.018 respectively). The average gestational week was 36.6 weeks in the study group and 36.7 weeks in the control group. The incidence of premature delivery in the study group was 25.0 / 4 / 16, which was higher than that in the control group (3.810 / 4 / 10 5), and the difference was statistically significant. The cesarean section rates in the two groups were 87.50.14 / 16) and 85.7 / 90 / 1055.There was no significant difference between the two groups (P = 0.848). The amniotic fluid, premature rupture of membranes, fetal distress, The incidence of fetal malformation, neonatal asphyxia, perinatal death, macrosomia and low birth weight infants had no significant difference (P 0.05); the incidence of neonatal hypoglycemia in the study group was higher than that in the control group. The difference was statistically significant (P 0.05). The Apgar score of neonatal 1 min in the study group was 8.25, which was lower than that in the control group (8.87). Conclusion the perinatal maternal and fetal morbidity was increased by ICP combined with GDM. Timely termination of pregnancy can reduce the perinatal maternal and fetal morbidity.
【作者单位】：中国人民解放军第451医院妇产科;
【基金】：西安市医学攻关项目[SF1324(4)]
【分类号】：R714.256

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