妊娠期肝内胆汁淤积症围产儿不良结局的研究

发布时间：2018-04-11 19:26

  本文选题：妊娠期肝内胆汁淤积症 + 早产　； 参考：《遵义医学院》2014年硕士论文

【摘要】：目的：探讨妊娠期肝内胆汁淤积症围产儿不良结局的相关问题。 方法：收集在成都大学附属医院和成都市金牛区妇幼保健院住院分娩ICP的病例。回顾性分析522例ICP病例的产科因素与围产儿不良结局之间的关系。 结果：(1)单因素分析发现发病时间、高TBA、高ALT、高TBIL、高DBIL、合并高血压有统计学意义(P0.05)；Logistic回归分析发现ICP的发病时间、高TBA、合并高血压系ICP围产儿不良结局的高危因素(P0.05)，其OR值分别为2.922、1.770、1.861。(2)重度组ICP围产儿的5种不良结局发生率均高于轻度组，统计学差异显著(P0.05)。(3)按发病时间不同分成三组的ICP围产儿不良结局发病率比较，统计学差异显著(P0.05)，卡方分割得出≤32W发病组在早产、出生窒息、羊水污染的发生率均高于另两组(P0.05)，，32+1-34W发病组的早产和小于胎龄儿发生率高于34W发病组(P0.05)。(4)瘙痒组与无瘙痒组；长时间瘙痒组与短时间瘙痒组的ICP围产儿不良结局发生率的比较，统计学差异不显著(P0.05)。 结论：TBA≥40μmol/L、发病时间、合并高血压系ICP围产儿不良结局的高危因素；重度ICP的围产不良结局发生率高于轻度，分度诊治可改善ICP围产儿预后；ICP围产儿的早产发生率随发病时间提前而升高，以32周发病来定义早发型ICP可能比34周更合适；瘙痒症状尚不能用作划分ICP分度和评判其围产结局的指标。
[Abstract]:Objective: to investigate the perinatal adverse outcome of intrahepatic cholestasis of pregnancy.Methods: ICP cases were collected in Chengdu University affiliated Hospital and Jinniu District Maternal and Child Health Hospital of Chengdu.The relationship between obstetrical factors and perinatal adverse outcome in 522 cases of ICP was retrospectively analyzed.Results the onset time of ICP was found by univariate analysis, high TBA, high alt, high TBI, high DBIL, and high hypertension. Logistic regression analysis showed that the onset time of ICP was significant.The high risk factor of adverse outcome of perinatal ICP with high TBA and hypertension (OR = 2.922 / 1.770 / 1.861.42)) the incidence of adverse outcome of perinatal ICP in severe group was higher than that in mild group.The statistical difference was not significant (P 0.05).Conclusion the incidence of adverse perinatal outcomes in patients with severe ICP was higher than that in mild ICP, and the incidence of adverse perinatal outcomes in patients with hypertension was significantly higher than that in patients with hypertension (鈮

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