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目的探讨妊娠期肝内胆汁淤积症(Intrahepatic Cholestasis of Pregnancy,ICP)围生儿出生即刻脐动脉血血气分析值和胎盘绒毛间隙及合体结节面积的变化及其相关性。方法选择ICP晚期妊娠60例,正常晚期妊娠25例,测定围生儿出生即刻脐动脉血血气分析值(PH值、血氧分压PO2及二氧化碳分压PCO2),运用体视学方法测量胎盘绒毛间隙及合体结节的面密度;分析血气分析值与胎盘结构之间的相关性。结果ICP患者胎盘绒毛间隙面密度减小,合体结节面密度增大,围生儿出生即刻脐动脉血pH值、PO2均显著降低,PCO2升高。胎儿脐动脉血pH值、PO2与胎盘绒毛间隙面密度呈正相关,与合体结节面密度呈负相关;PCO2值与绒毛间隙面密度呈负相关,而与合体结节面密度呈正相关。结论ICP患者胎盘血液灌流量减少,绒毛有效交换面积减小,易出现胎儿宫内缺氧。
Objective To investigate the changes and correlations of umbilical arterial blood gas (HbA1c), placental villous space and nodule area in perinatal neonates with intrahepatic cholestasis of pregnancy (ICP). Methods Sixty pregnant women with advanced pregnancy with ICP and 25 normal pregnant women with late pregnancy were enrolled in this study. Umbilical arterial blood gas (PH), partial pressure of oxygen (PO2) and partial pressure of carbon dioxide (PCO2) were measured at the time of birth. The placenta villi Gap and the nodular surface density; analysis of blood gas analysis and placental structure of the correlation between. Results ICP placental villi gap surface density decreased, nodules increased density, perinatal umbilical artery immediately after birth, pH, PO2 were significantly lower, PCO2 increased. Fetal umbilical arterial blood pH, PO2 and placental villi gap surface density was positively correlated with the fit nodular surface density was negatively correlated; PCO2 value villus gap surface density was negatively correlated with the fit nodular surface density was positively correlated. CONCLUSION: The decrease of placental blood perfusion and the effective area of villus exchange in ICP patients are prone to hypoxia in the fetus.