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目的:探讨肝内胆汁淤积症患者分度管理对围生儿预后的影响。方法:选择2002年1月～2009年1月确诊ICP患者324例,按照血清胆红素、肝酶和CG水平分为轻度和重度两组分别为202例和84例,同时随机抽取同期分娩的正常孕妇90例作为对照组,评估羊水污染程度,新生儿窒息情况,产后出血及分娩方式等。结果:ICP轻、重两组羊水Ⅱ度以上污染率明显高于正常对照组,差异有统计学意义(P<0.05);新生儿窒息重度ICP组明显高于轻度ICP组和正常组,差异有统计学意义(P<0.05);ICP轻、重两组早产发生率均高于正常组,差异有统计学意义(P<0.05);ICP重度和轻度组剖宫产率分别为95.23%和73.65%,较正常组剖宫产率35.84%差异有统计学意义(P<0.05);三组产后出血发生率差异无统计学意义(P>0.05),但随着肝酶和CG的升高,产后出血的发生率也在逐渐升高。结论:对ICP患者进行轻度和重度分度管理及处理后发现对围生儿预后是有影响的,尤其可以减少新生儿窒息及围产儿死亡率。
Objective: To investigate the effect of sub-degree management of intrahepatic cholestasis on the prognosis of perinatal infants. Methods: A total of 324 patients diagnosed with ICP from January 2002 to January 2009 were selected and divided into two groups according to the levels of serum bilirubin, liver enzymes and CG, which were 202 cases and 84 cases respectively. At the same time, 90 cases of normal pregnant women as a control group to assess the extent of amniotic fluid contamination, neonatal asphyxia, postpartum hemorrhage and delivery methods. Results: The pollution rate of amniotic fluid above the second degree of amniotic fluid in ICP group was significantly higher than that in normal control group (P <0.05), and severe neonatal asphyxia group was significantly higher than mild ICP group and normal group (P <0.05). The incidence of preterm birth in both light and heavy groups was significantly higher than that in normal group (P <0.05). The rates of cesarean section in severe and moderate ICP group were 95.23% And 73.65%, respectively, which was significantly higher than that of the normal group (35.84%, P <0.05). There was no significant difference in the incidence of postpartum hemorrhage between the three groups (P> 0.05) High, the incidence of postpartum hemorrhage is also gradually increased. CONCLUSIONS: Management and management of patients with mild and severe degrees of ICP have been found to have an impact on the prognosis of perinatal children, and in particular to reduce neonatal asphyxia and perinatal mortality.