妊娠期肝内胆汁淤积症患者与正常孕产妇的临床对照研究［摘要］目的探讨妊娠期肝内胆汁淤积症对孕妇妊娠及围生儿结局的影响。方法选择我院2009年9月〜2010年10月收治的妊娠期肝内胆汁淤积症患者73例作为观察组，选择同期健康孕妇70例作为对照组，比较两组孕妇妊娠及围生儿结局。结果观察组的早产、剖宫产率分别为12.3%、16.4%,均明显高于对照组的1.4%.4.3%,且观察组产后出血量明显多于对照组，组间差异均有统计学意义(P<0.05)；两组胎儿前置胎盘和脐带绕颈发生率间差异无统计学意义(P>0.05),而观察组羊水粪染发生率为15.1%,明显高于对照组的2.9%,组间差异有统计学意义(P<0.05)；观察组新生儿窒息、低体重儿的发生率分别为11.0%、19.2%,均明显高于对照组的1.4%、2.9%,且观察组新生儿Apgar评分明显低于对照组，组间差异均有统计学意义(P<0.05)o结论妊娠期肝内胆汁淤积症对孕妇妊娠及围生儿结局均有不良影响，临床应尽早发现并积极治疗，争取获得更好的母婴结局。［关键词］妊娠期；肝内胆汁淤积症；围生儿［］R714.255［文献标识码］B［］1673-9701(2011)20-156-03ClinicalControlStudyonIntrahepaticCholestasisofPregnancyandNormalPregnancyWomenYUZhizhiBin激angMaternalandChildCareServiceCentreofHangzhouCity,Hangzhou310052,China[Abstract]ObjectiveToobservetheinfluenceofintrahepaticcholestasisofpregnancyonoutcomeofpregnantwomenandperinatals.MethodsFromSeptember2009toOctober2010inourhospital,73casesofpregnantwomenwithintrahepaticcholestasiswereselectedastheobservationgroup,and70casesofhealthypregnantwomenduringthesameperiodasthecontrolgroup.Theoutcomeofpregnantwomenandperinatalsoftwogroupswereobserved.ResultsInobservationgroup,theprematurebirthrateandcesareansectionratewere12.3%and16.4%,significantlyhigherthan1.4%and4.3%ofthecontrolgroup,andthepostpartumhemorrhageoftheobservationgroupwassignificantlymorethanthecontrolgroup,thedifferenceswerestatisticallysignificantbetweentwogroups(P<0.05)；Theincidenceofplacentapreviaandcordaroundneckoftwogroupshadnosignificantdifference(P>0.05),buttheincidenceofmeconium-stainedamnioticfluidofobservationgroupwas15.1%,significantlyhigherthan2.9%ofthecontrolgroupandthedifferencewasstatisticallysignificant,betweentwogroups(P<0.05)；Inobservationgroup,theincidenceofneonatalasphyxiaandlowbirthweightchildrenwere11.0%and19.2%,weresignificantlyhigherthan1.4%and2.9%ofthecontrolgroup,andtheApgarscoresofobservationgroupweresignificantlylowerthanthecontrolgroup,thedifferenceswerestatisticallysignificantbetweentwogroups(P<0.05).ConclusionIntrahepaticcholestasisofpregnancyhasadverseeffectsonoutcomeofpregnantwomenandperinatals；Clinicalearlydetectionandaggressivetreatmentshouldbecarriedouttostriveforbettermaternalandneonataloutcomes.[Keywords]Pregnancy；Intrahepaticcholestasis；Perinatalinfant妊娠期肝内胆汁淤积症多于妊娠28〜32周出现，也有早至12周开始者。瘙痒程度不一，部位以手掌、脚掌为主，但无皮损出现，严重者全身瘙痒，严重影响孕妇的生活质量，也会引起孕妇以及家属的担心，怕影响到胎儿的正常发育[1]。笔者借助本研究妊娠期肝内胆汁淤积症对孕妇妊娠及围生儿结局的影响，现将有关资料总结分析如下。1资料与方法1.1一般资料者73例作为观察组，均根据病史、临床表现和实验室检查确诊，患者年龄24〜37岁，平均(29.5±3.0)岁；初产妇64例，经产妇9例；孕周36〜41周，平均(37.0±2.5)周；患者肝功能均有不同程度异常，主要表现为丙氨酸氨基转氨酶、天门冬氨酸氨基转氨酶不同程度升高，血清胆汁酸增高。选择同期我院收治的健康孕妇70例作为对照组，年龄24〜36岁，平均(28.8±2.6)岁；初产妇62例，经产妇8例；孕周35-41周,平均(37.5±3.0)周。两组患者的一般资料比较，差异均无统计学意义(P>0.05),具有临床...