妊娠期急性脂肪肝临床特征及预后不良相关因素探讨

发布时间：2018-04-17 12:56

本文选题：妊娠期急性脂肪肝 + 临床特征　；参考：《四川大学学报(医学版)》2017年05期

【摘要】：目的分析妊娠期急性脂肪肝(AFLP)的临床特征并探讨该病预后不良的相关因素。方法将2011年8月至2016年1月四川大学华西第二医院收治的36例AFLP患者纳入研究,依据临床结局分为两组:预后良好组(n=30)和预后不良组(n=6)。比较两组患者的一般资料、临床资料、实验室辅助检查、治疗措施等。结果临床特征的指标中产前患有妊娠期糖尿病的比例,产后出现宫缩乏力的比例,合并弥散性血管内凝血(DIC)、肝性脑病的比例,血浆置换率两组间比较差异具有统计学意义(P0.05);入院时辅助检查的实验室指标中凝血酶原时间(PT)、活化的部分凝血酶时间(APTT)、血糖(Glu)、总胆红素(TBIL)、直接胆红素(DBIL)、总蛋白(TP)两组间比较差异具有统计学意义(P0.05)。结论 AFLP是妊娠晚期的严重并发症,发病凶险,母婴死亡率高。AFLP患者预后不良多与起病后迅速出现凝血功能严重异常、血糖水平降低、TBIL水平增高和TP降低,且多并发消化道出血、肝性脑病等因素有关。
[Abstract]:Objective to analyze the clinical features of acute fatty liver disease (AFLP) in pregnancy and to explore the related factors of poor prognosis.Methods from August 2011 to January 2016, 36 patients with AFLP were divided into two groups according to their clinical outcomes: good prognosis group (n = 30) and poor prognosis group (n = 6).The general data, clinical data, laboratory assistant examination and treatment measures were compared between the two groups.Results among the clinical features, the proportion of gestational diabetes mellitus, postpartum uterine inertia, disseminated intravascular coagulation and hepatic encephalopathy were observed.The difference of plasma exchange rate between the two groups was statistically significant (P 0.05); prothrombin time (PTT), activated partial thrombin time (APTTT), blood glucose (Glun), total bilirubin (TBILL), direct bilirubin (DBIL), total protein (TPTP) were measured in the laboratory parameters of the adjuvant examination at admission.The difference between the two groups was statistically significant (P 0.05).Conclusion AFLP is a serious complication in late pregnancy. The prognosis of the patients with high maternal and infant mortality is poor and the coagulation function is abnormal rapidly after the onset of the disease. The level of blood sugar decreases and the level of TBIL increases and TP decreases.And many complicated with gastrointestinal hemorrhage, hepatic encephalopathy and other factors related.
【作者单位】：四川大学华西第二医院妇产科ICU;出生缺陷与相关妇儿疾病教育部重点实验室(四川大学);四川大学华西第二医院麻醉科;四川大学华西第二医院区域联盟医院资阳市妇幼保健院;四川省眉山市人民医院妇产科;四川大学华西基础医学与法医学院法医物证学教研室;四川大学华西第二医院遗传实验室;四川大学华西第二医院妇产科;
【分类号】：R714.255

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