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目的分析早发型妊娠肝内胆汁淤积症(ICP)患者的发病特点,有助于临床治疗及预后判断。方法对该院4年来收治的10例早发型ICP患者的临床资料进行回顾性分析。结果早发型ICP发病孕周最早在孕10周,以皮肤瘙痒为首发症状,皮肤瘙痒的部位以四肢为重。对于早发型ICP患者采用中西医结合的综合治疗方法,同时进行密切的胎儿监护,安宝抑制宫缩,地塞米松促胎肺成熟,适时终止妊娠。终止妊娠孕周为孕33～37周,终止妊娠的方式均采用剖宫产。其中1例在孕30周放弃治疗要求引产。无1例围生儿死亡,随访病例中无脑瘫及智力障碍发生。结论早发型ICP发病虽早,但经中西医结合综合治疗后到晚期妊娠有好转趋势,母婴预后良好。
Objective To analyze the incidence of early-onset intrahepatic cholestasis of pregnancy (ICP), which is helpful for clinical treatment and prognosis. Methods The clinical data of 10 patients with early-onset ICP admitted to our hospital for 4 years were retrospectively analyzed. Results The onset of early-onset ICP was the earliest gestational age of 10 weeks pregnant with pruritus as the first symptom, the site of pruritus to limbs as the most important. For early-onset ICP patients with integrated traditional and western medicine treatment, while close fetal care, contraindications to inhibit contractions, dexamethasone to promote fetal lung maturity, timely termination of pregnancy. Cessation of gestational weeks of pregnancy for 33 to 37 weeks, termination of pregnancy are used cesarean section. One case of giving up treatment at 30 weeks of pregnancy requires induction of labor. No one perinatal death, follow-up cases without cerebral palsy and mental retardation. Conclusions Although the incidence of early onset ICP is early, but after the combination of traditional Chinese and Western medicine to late pregnancy trends have improved, the mother and child prognosis is good.