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目的探讨妊娠期肝内胆汁淤积症(ICP)脐动脉血流比值对新生儿预后的影响。方法选取2013年9月~2014年8月间该院收治的108例ICP孕妇为观察组;同时选取在该院健康体检的108例正常孕妇为对照组。对比两组孕妇肝功能指标:谷草转氨酶(AST)、谷丙转氨酶(ALT)、血清总胆汁酸(TBA);围产儿结局:新生儿体重、早产、胎儿窘迫等;脐动脉血流检测指标:波动指数(PI值)、阻力指数(RI值)、血流收缩期和舒张期的比值(S/D值)。结果观察组患者AST、ALT、TBA水平均明显高于对照组,差异有统计学意义(P<0.01)。观察组新生儿体重明显低于对照组,早产、胎儿窘迫、新生儿窒息等发生率明显高于对照组,差异均有统计学意义(P<0.05)。观察组RI值和S/D值均明显高于对照组,差异有统计学意义(P<0.01);两组间PI值差异无统计学意义(P>0.05)。结论 ICP孕妇应定期检测脐动脉血流情况,便于尽早采取干预措施,改善围产儿结局。
Objective To investigate the effect of pregnancy-induced intrahepatic cholestasis (ICP) on the prognosis of newborns. Methods A total of 108 pregnant women undergoing ICP in our hospital from September 2013 to August 2014 were selected as the observation group. 108 normal pregnant women undergoing physical examination in the hospital were selected as the control group. The indexes of liver function were compared between the two groups: AST, ALT and TBA; Perinatal outcome: weight of newborns, premature birth, fetal distress, etc .; indicators of umbilical artery blood flow: Volatility index (PI), resistance index (RI), systolic and diastolic ratio (S / D). Results The levels of AST, ALT and TBA in the observation group were significantly higher than those in the control group (P <0.01). The birth weight of the observation group was significantly lower than that of the control group. The incidence of preterm birth, fetal distress and neonatal asphyxia were significantly higher than those of the control group (P <0.05). The values of RI and S / D in the observation group were significantly higher than those in the control group (P <0.01). There was no significant difference in PI between the two groups (P> 0.05). Conclusion ICP pregnant women should regularly test umbilical artery blood flow, facilitate the early intervention to improve perinatal outcome.