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目的通过分析总结急性妊娠脂肪肝(acute fatty liver of pregnancy,AFLP)的临床特点,为临床确定有效的治疗方案及减少母婴死亡提供依据。方法对2006年1月-2009年10月收治7例AFLP患者,年龄23~32岁。初产妇5例,经产妇2例(宫内死胎1例)。孕周33~38周。对6例产前发病患者以剖宫产终止妊娠,给予对症处理;1例产后发病患者直接入ICU治疗。结果6例产前发病者,5例各项指标较快恢复正常,母婴存活,术后10d出院;1例剖宫取胎后转ICU治疗,术后好转出院。1例产后发病患者因多脏器衰竭、弥散性血管内凝血抢救无效死亡。结论AFLP是妊娠晚期特发性致死的严重并发症,早期诊断和积极有效的处理是良好预后的关键,应引起产科工作者的重视。
Objective To analyze and summarize the clinical features of acute fatty liver of pregnancy (AFLP) and provide evidence for effective clinical treatment and reduction of maternal and infant mortality. Methods From January 2006 to October 2009, 7 patients with AFLP were treated, aged 23-32 years. 5 cases of primipara, 2 cases of mothers (intrauterine fetal death in 1 case). 33 to 38 weeks gestational age. 6 cases of prenatal patients with cesarean termination of pregnancy, given symptomatic treatment; 1 case of postpartum patients directly into the ICU treatment. Results In 6 prenatal cases, all the 5 indexes recovered quickly and maternal and infant survived. They were discharged 10 days after operation. One case of ICU was removed after cesarean section and was discharged after surgery. One case of postpartum patients died of multiple organ failure, disseminated intravascular coagulation rescue invalid. Conclusion AFLP is a serious complication of idiopathic lethargy in the third trimester of pregnancy. Early diagnosis and active treatment are the keys to good prognosis, which should be paid more attention to by obstetricians.