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1、妊娠期肝内胆汁瘀积症的治疗与围产儿预后关系的探讨【关键词】妊娠期肝内胆汁瘀积症[摘要]目的:评估熊去氧胆酸(UDCA)、地塞米松(DX)治疗妊娠期肝内胆汁瘀积症(ICP)的疗效及围产儿预后情况。方法:126例患者随机分为UDCA组(A组、DX组(B组)和对照组(C组),各42例,A、B、C3组血清胆汁酸TBA(10〜50nmol/L)分别为A1组30例、B1组27例、C1组29例;TBA>50umol/L分别为A2组12例、B2组15例、C2组13例。A组给予UDCAlOOmg,3次/d,14d为1个疗程;B组给予DX3mg,3
2、次/d,10d后逐渐减量而停药;C组给予口服维生素CO.2g,连续服用14do结果:A、B组患者治疗后皮肤瘙痒症状明显减轻(P<0.05),C组瘙痒症状无变化;A、B2组治疗后血TBA明显下降(P〈0・05);A2组下降程度大于B2组(PC0.05),C组稍上升(P〉0・05);3组内早产、胎儿窘迫、新生儿窒息的发生率与TBA值呈正相关,A、B组的发生率明显低于C组,差异有显著性(P〈0・05),A、B组内TBA值低的组(A1、B1组)早产、胎儿窘迫、新生儿窒息发生率差异无显著性(P>0.05),TAB值高的组(A2、B2组)早
3、产、胎儿窘迫、新生儿窒息的发生率差异有显著性(P〈0.05)。结论:UDCA、DX均能有效治疗ICP,减少早产、胎儿窘迫、新生儿窒息的发生率,对于TBA值高的患者,UDCA疗效优于DX,仅口服维生素C不能有效治疗ICPo[关键词]妊娠期肝内胆汁瘀积症;血清胆汁酸;熊去氧胆酸;胎儿窘迫;新生儿窒息RelationshipbetweentreatmentofintrahepaticcholestasisduringpregnancyandprognosisofprenataiinfantWANGZhong-ying,LINYin-x
4、iang(SuixiPeople,sHospital,Suixi524300,China)Abstract:Toevaluatetheeffectofursodeoxycholicacid(UDCA)anddexamethasone(DX)onintrahepaticcholestasisduringpregnancyandprognosisoftheperinatalinfant・Methods:126patientswererandomlydividedintotheUDCAgroup(GroupA),DXgroup(Gro
5、upB)andthecontrolgroup(GroupC),with42patientsineachgroup・Andpatientsinthe3groupswerefurtherdividedintotwosub-groupsinaccordancewiththelevelofserumbileacid・Therewere30casesinA1,27casesinB1,and29casesinC1,with10umol/L6、roupB2,andl3casesinGroupC2respec-tively,withTBA>50umol/L.PatientsinGroupAweretreatedwithUDCA,atadoseoflOOmg,3timesadayforasuccessionof14days・PatientsinGroupBweretreatedwithDX,atadoseof3mg,also3timesadayforasuccessionoflOdays,afterwhichmedicationwasreducedandfinallyte
7、rminated・PatientsinGroupCweregivenvitaminC,0.3g,3timesadayforasuccessionof14days・ResuIts:ForpatientsinGroupAandGroupB,thesymptomofprurituswasreleasedsignificantlyaftertreatment(P<0.05),whilesymptomremainedunchangedforpatientsinGroupC・ThelevelofserumbileacidinGroupAan
8、dBreducedsignificantly(P<0.05),withthereductioninTBAbeinggreaterinA2thanthatinB2(P<0.05),whilethatofGroupCroseslightly(P<0.05)・Inci