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目的探讨熊去氧胆酸治疗妊娠期肝内胆汁淤积症(ICP)的疗效及对妊娠结局的影响。方法选取2014年12月-2015年12月南通大学附属海安人民医院期间收治的60例重度妊娠期肝内胆汁淤积症(ICP)患者,根据是否服用熊去氧胆酸片随机分为对照组和观察组,每组各30例;两组均给予吸氧等常规治疗。60例患者在治疗前后均检测肝功能指标,对比并评价两组治疗后的瘙痒程度,记录胎儿娩出后的脐静脉血总胆汁酸(TBA)、丙氨酸氨基转移酶(ALT)和总胆红素(TBIL)水平;记录治疗过程中出现的不良反应及其应对措施。结果治疗后,观察组与对照组的肝功能指标都有所下降,但观察组下降明显(P<0.001);与对照组相比,观察组的瘙痒程度降低(χ~2=10.559,P=0.014),娩出胎儿后的脐静脉血总胆汁酸和TBIL水平比较,差异具有统计学意义(t=3.881、13.251,均P<0.001),但ALT水平无明显变化(t=0.163,P=0.871)。结论熊去氧胆酸片能有效提高ICP患者围生期结局,降低胎儿死亡率。
Objective To investigate the efficacy of ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy (ICP) and its effect on pregnancy outcome. Methods Sixty patients with severe intrahepatic cholestasis of pregnancy (ICP) admitted during the period from December 2014 to December 2015 in Haian People’s Hospital affiliated to Nantong University were randomly divided into control group and control group according to whether taking ursodeoxycholic acid tablets Observation group, each group of 30 cases; both groups were given conventional oxygen therapy. Sixty patients were tested for liver function before and after treatment. The degree of pruritus was compared between the two groups after treatment. The total bile acid (TBA), alanine aminotransferase (ALT) and total cholesterol The level of TBIL was recorded. The adverse reactions and their coping measures during the treatment were recorded. Results After treatment, the indexes of liver function of the observation group and the control group decreased, but the observation group decreased significantly (P <0.001). Compared with the control group, the degree of pruritus decreased (χ ~ 2 = 10.559, P = 0.014). The levels of total bile acid and TBIL in umbilical venous blood after delivery were statistically different (t = 3.881, 13.251, both P <0.001), but there was no significant difference in ALT level (t = 0.163, P = 0.871 ). Conclusion Ursodeoxycholic acid tablets can effectively improve ICP perinatal outcome and reduce fetal mortality.