妊娠期肝内胆汁淤积症238例临床分析

目的：探讨妊娠期肝内胆汁淤积症（ICP）的发病率、诊断、围产期并发症及防治对策。方法：对本院近5年发生的2384例ICP病例分治疗组（132例）和未治组（106例）进行回顾性分析。结果：治疗组各项血生化指标明显下降、围生儿死亡率、宫内窘迫、新生儿窒息、早产及产后出血率明显低于对照组。结论：加强对ICP的早期诊断、早期治疗，仔细观察多项临床及实验室指标变化，如胎心胎动、NST胎心基线变异、血清转氨酶、胆红素和总胆汁酸，及早发现胎儿宫内窘迫，适时终止妊娠是降低围产儿死亡的关键，也可降低产后出血发生率。

Clinical Analysis of 238 Cases with Intrahepatic Cholestasis in Pregnancy

Objective:To discuss the incidence,diagnosis and management of intrahepatic cholestasis of pregnancy(ICP).Methods:238 cases with ICP in our hospital for nearly 5 years were analyzed,with 132 cases in the treatment group and 106 in the control group.Results:In treatment group,the incidence of perinatal mortality,fetal distress and asphyxia of newborn infants were significantly lower than those in the control group(P<0.01).Conclusions:It is essentialto diagnose and treat ICP early,and observe carefully variation of multiple clinical and laboratorial indexes,such as fetal heart rate and fetal movement,variation of fetal heart rate baseline in NST,serum concentration of transaminase,bilirubin and tatal bile acide(TBA).To find out fetal distress earlier,and determine the opportunity for delivery could reduce perinatal mortality and postpartum hemorrhage.