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目的:探讨西宁地区妊娠肝内胆汁淤积症(ICP)分度管理对围生儿的影响,为妊娠肝内胆汁淤积症分度治疗的合理性提供临床依据。方法:将129例ICP患者分成轻、重两组,比较两组对药物治疗前后的生化指标和临床症状的变化,观察两组患者围生儿发生危险的时间,决定适当的分娩时间。结果:轻度患者对药物反应性较好,重度患者对药物反应性较差。轻度患者发生围生儿窒息和羊水污染的时间较晚,重度患者发生围生儿窒息及羊水污染时间早。结论:轻型患者可药物治疗至足月,期待阴道分娩,重度患者应适时剖宫产终止妊娠。妊娠肝内胆汁淤积症患者的分型可减少医源性早产及围生儿发病率,减少ICP患者围生儿的死亡率。
OBJECTIVE: To investigate the effect of pregnancy-induced intrahepatic cholestasis (ICP) index management in perinatal infants in Xining area to provide a clinical basis for the rationality of indexing therapy for intrahepatic cholestasis of pregnancy. Methods: 129 cases of ICP patients were divided into mild and severe groups. The changes of biochemical indexes and clinical symptoms before and after treatment were compared between two groups. The risk of perinatal children was observed in two groups and the appropriate delivery time was determined. Results: Mild patients responded better to drugs and patients with severe ones were less responsive to drugs. Mild patients with perinatal asphyxia and amniotic fluid contamination later, severe perinatal asphyxia and amniotic fluid contamination occurred earlier. Conclusions: Patients with light-weight can be treated with drugs until full-term, expecting vaginal delivery, and severe patients should be terminated by cesarean section. The classification of patients with intrahepatic cholestasis of pregnancy can reduce the morbidity of iatrogenic preterm and perinatal children and reduce the perinatal mortality in ICP patients.