本文選題：妊娠期肝內(nèi)膽汁淤積癥 + 胎兒死亡　； 參考：《重慶醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的利用系統(tǒng)評(píng)價(jià)的方法探討ICP孕婦血清TBA水平與胎兒死亡之間的關(guān)系。 方法：通過(guò)檢索有關(guān)ICP及血清TBA水平與胎兒死亡之間的關(guān)系的病例對(duì)照研究文獻(xiàn)、個(gè)案報(bào)告文獻(xiàn)及病例總結(jié)文獻(xiàn)。通過(guò)Revman5.2軟件對(duì)可合并的病例對(duì)照文獻(xiàn)進(jìn)行薈萃分析，對(duì)于不能合并分析的病例對(duì)照文獻(xiàn)、個(gè)案報(bào)告及病例總結(jié)文獻(xiàn)，利用描述性系統(tǒng)評(píng)價(jià)方法進(jìn)行文獻(xiàn)評(píng)價(jià)。 結(jié)果共納入文獻(xiàn)18篇。根據(jù)薈萃分析結(jié)果，ICP孕婦圍產(chǎn)兒死亡的發(fā)生率為1.91%，與正常妊娠孕婦相比，ICP患者胎兒死亡的發(fā)病率有顯著統(tǒng)計(jì)學(xué)差異（OR2.6595%CI1.66-4.24P0.0001）；對(duì)于ICP患者，當(dāng)孕婦血清TBA≥40μmol/L時(shí)，胎兒死亡風(fēng)險(xiǎn)顯著升高（OR11.51P=0.0001）。根據(jù)描述性系統(tǒng)評(píng)價(jià)結(jié)果，納入不能合并分析ICP死胎文獻(xiàn)6篇，共包含26例胎兒死亡病例，對(duì)孕婦血清TBA平進(jìn)行描述，其TBA水平均明顯升高，絕大多數(shù)大于40μmol/L，但TBA水平小于40μmol/L時(shí)，亦可發(fā)生胎兒死亡。1篇病例對(duì)照文獻(xiàn)比較分析所有死胎及活產(chǎn)病例母血TBA水平差異，，共納入死胎病例581例，活產(chǎn)病例1564例，其平均TBA水平均正常，兩者比較，TBA水平無(wú)統(tǒng)計(jì)學(xué)差異。 結(jié)論系統(tǒng)評(píng)價(jià)文獻(xiàn)表明ICP孕婦血清TBA水平超過(guò)40μmol/L時(shí)胎兒死亡風(fēng)險(xiǎn)增高，但I(xiàn)CP孕婦血清TBA水平低于40μmol/L時(shí)仍應(yīng)警惕胎兒死亡的可能。
[Abstract]:Objective to study the relationship between serum TBA level and fetal death in ICP pregnant women. Methods: a case-control study on the relationship between ICP and serum TBA levels and fetal death was conducted. A meta-analysis was carried out on the combined case-control literature by Revman 5.2 software. For the case control literature, case report and case summary literature that could not be combined, the descriptive system evaluation method was used to evaluate the literature. Results A total of 18 articles were included. According to the results of meta-analysis, the perinatal mortality rate of ICP pregnant women was 1.91. The incidence of fetal death in ICP patients was significantly different from that in normal pregnant women (OR 2.6595CI1.66-4.24P0.0001), and for ICP patients, when the serum TBA was 鈮

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