本文選題：妊娠期肝內(nèi)膽汁淤積癥 + 早產(chǎn)��； 參考：《遵義醫(yī)學(xué)院》2014年碩士論文

【摘要】：目的：探討妊娠期肝內(nèi)膽汁淤積癥圍產(chǎn)兒不良結(jié)局的相關(guān)問題。 方法：收集在成都大學(xué)附屬醫(yī)院和成都市金牛區(qū)婦幼保健院住院分娩ICP的病例。回顧性分析522例ICP病例的產(chǎn)科因素與圍產(chǎn)兒不良結(jié)局之間的關(guān)系。 結(jié)果：(1)單因素分析發(fā)現(xiàn)發(fā)病時間、高TBA、高ALT、高TBIL、高DBIL、合并高血壓有統(tǒng)計學(xué)意義(P0.05)；Logistic回歸分析發(fā)現(xiàn)ICP的發(fā)病時間、高TBA、合并高血壓系ICP圍產(chǎn)兒不良結(jié)局的高危因素(P0.05)，其OR值分別為2.922、1.770、1.861。(2)重度組ICP圍產(chǎn)兒的5種不良結(jié)局發(fā)生率均高于輕度組，統(tǒng)計學(xué)差異顯著(P0.05)。(3)按發(fā)病時間不同分成三組的ICP圍產(chǎn)兒不良結(jié)局發(fā)病率比較，統(tǒng)計學(xué)差異顯著(P0.05)，卡方分割得出≤32W發(fā)病組在早產(chǎn)、出生窒息、羊水污染的發(fā)生率均高于另兩組(P0.05)，，32+1-34W發(fā)病組的早產(chǎn)和小于胎齡兒發(fā)生率高于34W發(fā)病組(P0.05)。(4)瘙癢組與無瘙癢組；長時間瘙癢組與短時間瘙癢組的ICP圍產(chǎn)兒不良結(jié)局發(fā)生率的比較，統(tǒng)計學(xué)差異不顯著(P0.05)。 結(jié)論：TBA≥40μmol/L、發(fā)病時間、合并高血壓系ICP圍產(chǎn)兒不良結(jié)局的高危因素；重度ICP的圍產(chǎn)不良結(jié)局發(fā)生率高于輕度，分度診治可改善ICP圍產(chǎn)兒預(yù)后；ICP圍產(chǎn)兒的早產(chǎn)發(fā)生率隨發(fā)病時間提前而升高，以32周發(fā)病來定義早發(fā)型ICP可能比34周更合適；瘙癢癥狀尚不能用作劃分ICP分度和評判其圍產(chǎn)結(jié)局的指標(biāo)。
[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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