【摘要】：目的：觀察妊娠合并乙型肝炎病毒（HBV）感染母嬰結(jié)局，提高對妊娠合并HBV感染孕婦管理的認(rèn)識，，加強(qiáng)對妊娠合并HBV感染的母嬰監(jiān)測，改善母嬰結(jié)局。 方法：選取2013年1月至2014年2月在廣西醫(yī)科大學(xué)第一附屬醫(yī)院產(chǎn)前檢查并分娩、孕期初診為HBV感染（血清HBsAg陽性）的孕婦40例，作為妊娠合并HBV感染妊娠結(jié)局的研究對象，其中肝功能異常者12例，肝功能正常者28例；隨機(jī)選取相同醫(yī)院、同期血清HBsAg陰性并且肝功能正常的孕婦60例作為對照組。所以孕婦排除了甲、丙、丁、戊型肝炎病毒感染，無其他肝膽疾��；排除可能影響妊娠結(jié)局的胎盤早剝、胎盤前置、糖尿病等合并癥。對所選病例的臨床資料進(jìn)行回顧性分析，比較肝功能正常組、異常組和對照組三組母嬰結(jié)局。 結(jié)果：1.肝功能正常組、異常組和對照組孕婦早產(chǎn)、胎兒窘迫、妊娠期高血壓疾病、胎膜早破及產(chǎn)后出血發(fā)生率，肝功能異常組最高、對照組最低。肝功能異常組與對照組比較，早產(chǎn)、妊娠期高血壓疾病和產(chǎn)后出血發(fā)生率明顯較高（25.0%vs3.3%、P=0.03，33.3%vs5.0%、P=0.013，33.3%vs3.3%、P=0.004）；胎兒窘迫、胎膜早破發(fā)生率略高，無明顯差異（P0.05）。三組剖宮產(chǎn)率之間均無明顯差異（P0.05）。2.肝功能異常組低體重兒、新生兒窒息和死胎發(fā)生率最高，低體重兒發(fā)生率明顯高于對照組（25.0%vs3.3%、P=0.03）；新生兒窒息發(fā)生率略高于肝功能正常組和對照組，無明顯差異（P0.05）。肝功能正常組低體重兒和新生兒窒息發(fā)生率略高對照組，無顯著差異(P0.05）。 結(jié)論：妊娠合并HBV感染對母嬰結(jié)局造成不良影響,尤其存在肝功能異常時(shí)對母兒危害更大；對孕婦常規(guī)地進(jìn)行HBV血清學(xué)和肝功能檢測，重視產(chǎn)前檢查和圍生期監(jiān)測，以改善母嬰結(jié)局。妊娠合并HBV感染不增加剖宮產(chǎn)率、對分娩方式影響較小。
[Abstract]:Objective: to observe the maternal and infant outcome of pregnancy with hepatitis B virus (HBV) infection, to improve the management of pregnant women with HBV infection, to strengthen the maternal and infant monitoring of pregnancy complicated with HBV infection, and to improve the maternal and infant outcome. Methods: from January 2013 to February 2014, 40 pregnant women with HBV infection (serum HBsAg positive) at the first affiliated Hospital of Guangxi Medical University were selected as the study objects of pregnancy complicated with HBV infection. There were 12 cases with abnormal liver function and 28 cases with normal liver function. 60 pregnant women with negative serum HBsAg and normal liver function in the same hospital were randomly selected as control group. So pregnant women excluded hepatitis A, C, D, E virus infection, no other hepatobiliary diseases; exclusion of placental abruption, placenta previa, diabetes and other complications that may affect the outcome of pregnancy. The clinical data of the selected cases were analyzed retrospectively to compare the maternal and infant outcomes of normal liver function group, abnormal group and control group. Results: 1. In normal liver function group, abnormal group and control group, the incidence of premature delivery, fetal distress, hypertensive disorder complicating pregnancy, premature rupture of membranes and postpartum hemorrhage were the highest in the abnormal group and the lowest in the control group. The incidence of preterm labor, hypertension complicating pregnancy and postpartum hemorrhage in the abnormal liver function group was significantly higher than that in the control group (25.0 vs 3.3%). Fetal distress, premature rupture of membranes slightly higher, there was no significant difference (P0.05). There was no significant difference in cesarean section rate among the three groups (P0.05). The incidence of asphyxia and stillbirth was the highest in the group with abnormal liver function, and the incidence of low birth weight was significantly higher than that in the control group (25.0 vs 3.3%). The incidence of neonatal asphyxia was slightly higher than that of normal liver function group and control group, and there was no significant difference (P0.05). The incidence of low birth weight infants and neonatal asphyxia in normal liver function group was slightly higher than that in control group (P0.05). Conclusion: pregnancy with HBV infection has a negative effect on the outcome of mother and child, especially when there is abnormal liver function, it is more harmful to mother and infant. Routine HBV serology and liver function test were performed on pregnant women, and prenatal examination and perinatal monitoring were emphasized to improve the outcome of mother and child. Pregnancy complicated with HBV infection did not increase the rate of cesarean section, but had little effect on delivery mode.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R714.251

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉文瓊;;妊娠合并乙型肝炎病毒感染臨床分析[J];重慶醫(yī)學(xué);2006年11期

2 閆永平,徐德忠,王福生,門可,劉志華;乙型肝炎病毒宮內(nèi)感染的機(jī)制[J];第四軍醫(yī)大學(xué)學(xué)報(bào);2001年06期

3 袁榮,王晨虹,劉曉梅,王小青;HBV母嬰傳播致新生兒免疫失敗的原因和機(jī)制[J];第四軍醫(yī)大學(xué)學(xué)報(bào);2005年07期

4 郭培奮,鐘梅,侯金林;乙型肝炎病毒宮內(nèi)傳播的分型[J];第一軍醫(yī)大學(xué)學(xué)報(bào);2002年04期

5 張瑾,王戰(zhàn)會(huì),候金林,楊虹,程愛林,李秀惠;乙型肝炎病毒S基因變異株在母嬰向的選擇性傳播[J];第一軍醫(yī)大學(xué)學(xué)報(bào);2002年09期

6 尹玉竹;諶小衛(wèi);李小毛;侯紅瑛;史眾杰;;HBV宮內(nèi)感染的危險(xiǎn)因素及與HBV DNA的關(guān)系[J];南方醫(yī)科大學(xué)學(xué)報(bào);2006年10期

7 姚展成;陳明純;廖文燕;張艷萍;吳毅;李麗燕;馮晶;林美珊;陳楚昂;鄭定綱;莊見齊;;替比夫定阻斷乙型肝炎病毒宮內(nèi)感染效果和安全性研究[J];實(shí)用肝臟病雜志;2011年04期

8 于廣軍;乙型肝炎病毒母嬰傳播及其免疫學(xué)預(yù)防的研究進(jìn)展[J];國外醫(yī)學(xué)(流行病學(xué)傳染病學(xué)分冊);1996年04期

9 盧永平;陳友鵬;肖小敏;梁旭競;李健;黃思敏;陳新;HOCHER Berthold;;孕婦HBsAg攜帶狀態(tài)對早產(chǎn)發(fā)生的影響[J];南方醫(yī)科大學(xué)學(xué)報(bào);2012年09期

10 劉凌芝;鄭九生;余小紅;劉淮;蔡慶華;歐陽吁;;乙型肝炎病毒宮內(nèi)感染相關(guān)因素的探討[J];江西醫(yī)學(xué)院學(xué)報(bào);2006年05期

本文編號：2309060