摘要
目的探讨妊娠期肝内胆汁淤积症(ICP)对围生儿的影响。方法选择2002年3月至2003年8月在江西省妇幼保健院住院的ICP孕妇60例,分为轻度ICP组(42例)和重度ICP组(18例)。选择同期正常孕妇25例为对照组。检测ICP患者母体肝功能、胆汁酸,以出生即刻胎儿脐动脉血血气分析值作为围生儿预后的判断指标,同时运用体视学方法测量ICP患者胎盘绒毛间隙及合体结节面积,分析各组间围生儿脐动脉血血气分析值、胎盘绒毛间隙面积及合体结节面积的差异。结果(1)重度ICP组的脐动脉血pH值7.22±0.07、PO2(17.93±7.22)mmHg(1mmHg=0.133kPa),较轻度ICP组pH值7.27±0.06、PO2(22.92±6.15)mmHg及对照组pH值7.29±0.05、PO2(24.64±6.38)mmHg明显降低(P<0.01)。(2)重度ICP组PCO2(48.25±6.35)mmHg较轻度ICP组(43.81±7.21)mmHg及对照组(42.68±6.14mmHg)明显升高(P<0.01)。(3)重度ICP组绒毛间隙平均截面面积(6.0±1.0)μm2较轻度ICP组(6.9±1.3)μm2及对照组(7.2±0.8)μm2明显减小(P<0.01);合体结节平均截面面积(5.8±1.9)μm2较轻度ICP组(2.1±1.0)μm2和对照组(1.8±0.8)μm2明显增大(P<0.01)。轻度ICP组的脐动脉血pH值及PO2、PCO2、绒毛间隙平均截面面积及占总面积百分比、合体结节平均截面面积及占总面积百分比与对照组比较差异均无统计学意义。结论轻度ICP对围生儿影响较小,而重度ICP宫内氧交换面积明显减少,应引起高度重视,以免出现胎儿宫内不测。
Objective To study the influence of intrahepatic cholestasis of pregnancy （ICP） for perinatal prognosis. Methods 60 ICP cases were diagnosed in Jiangxi Maternity and Child Hygiene Hospital between March 2002 and August 2003 as the mild ICP group （n = 42） and the severe ICP group （n = 18 ）. 25 cases of healthy pregnant woman were chosen in synchronization as the control group. The liver function and acid bile of ICP patients were detected. We made the level of umbilical arterial blood gas analysis as the prognostic index, used the stereology method to survey the placental intervillous lacuna and the area of zoarium nodus at the same time. To analyzed the dependability between the index of liver function, acid bile and level of umbilical arterial blood gas analysis, placental intervillous lacuna, and the area of zoarium nodus. Results The numbers of pH （7.22 ± 0. 07） and PO2 （ 17.93 ±7.22） in arteria umbilical of severe ICP were significant lower （P 〈 0.01 ） than which in mild ICP [ pH = 7.27± 0.06, PO2 = （22.92 ± 6.15 ） mmHg ] and in the control group [ pH = 7.29±0.05, PO2 = （24.64± 6.38 ） mmHg ]. The number of PCO2 （48.25 ± 6. 35 ） in severe ICP is higher than which in mild ICP（43.81 ± 7.21 ）and the control group（42.68 ± 6.14） （P 〈 0.01 ）. The average of sectional area of intervillous lacuna in severe ICP （ 6.0 ± 1. 0） is smaller than which in mild ICP （ 6.9 ± 1.3 ） and the control group （ 7.2 ± 0.8 ） （ P 〈 0.01 ）. The average of sectional area of zoarium nodus （ 5.8± 1.9 ） is bigger than which in mild ICP （2.1 ± 1.0） and the control group （ 1.8 ± 0.8 ） （ P 〈 0.01 ） ; there was no significant difference between the mild ICP group and the control group. Conclusion The mild ICP has small influence to perinatal prognosis. The placental area for transport of oxygen in the severe ICP is decreased, so we should pay more attention to the severe ICP.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2009年第11期856-858,共3页
Chinese Journal of Practical Gynecology and Obstetrics
基金
江西省卫生厅重大招标项目(200219)
