本文選題：妊娠期急性脂肪肝 + 臨床特征��； 參考：《四川大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年05期

【摘要】：目的分析妊娠期急性脂肪肝(AFLP)的臨床特征并探討該病預(yù)后不良的相關(guān)因素。方法將2011年8月至2016年1月四川大學(xué)華西第二醫(yī)院收治的36例AFLP患者納入研究,依據(jù)臨床結(jié)局分為兩組:預(yù)后良好組(n=30)和預(yù)后不良組(n=6)。比較兩組患者的一般資料、臨床資料、實(shí)驗(yàn)室輔助檢查、治療措施等。結(jié)果臨床特征的指標(biāo)中產(chǎn)前患有妊娠期糖尿病的比例,產(chǎn)后出現(xiàn)宮縮乏力的比例,合并彌散性血管內(nèi)凝血(DIC)、肝性腦病的比例,血漿置換率兩組間比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05);入院時(shí)輔助檢查的實(shí)驗(yàn)室指標(biāo)中凝血酶原時(shí)間(PT)、活化的部分凝血酶時(shí)間(APTT)、血糖(Glu)、總膽紅素(TBIL)、直接膽紅素(DBIL)、總蛋白(TP)兩組間比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 AFLP是妊娠晚期的嚴(yán)重并發(fā)癥,發(fā)病兇險(xiǎn),母嬰死亡率高。AFLP患者預(yù)后不良多與起病后迅速出現(xiàn)凝血功能?chē)?yán)重異常、血糖水平降低、TBIL水平增高和TP降低,且多并發(fā)消化道出血、肝性腦病等因素有關(guān)。
[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.
【作者單位】： 四川大學(xué)華西第二醫(yī)院婦產(chǎn)科ICU;出生缺陷與相關(guān)婦兒疾病教育部重點(diǎn)實(shí)驗(yàn)室(四川大學(xué));四川大學(xué)華西第二醫(yī)院麻醉科;四川大學(xué)華西第二醫(yī)院區(qū)域聯(lián)盟醫(yī)院資陽(yáng)市婦幼保健院;四川省眉山市人民醫(yī)院婦產(chǎn)科;四川大學(xué)華西基礎(chǔ)醫(yī)學(xué)與法醫(yī)學(xué)院法醫(yī)物證學(xué)教研室;四川大學(xué)華西第二醫(yī)院遺傳實(shí)驗(yàn)室;四川大學(xué)華西第二醫(yī)院婦產(chǎn)科;
【分類號(hào)】：R714.255

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