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目的:探讨妊娠期急性脂肪肝的孕妇腹部超声特点。材料和方法:收集上海市公共卫生临床中心31例AFLP患者病史、腹部超声及血清总胆红素黄疸资料。结果:根据其肝超声三种表现分为三组,第一组脂肪肝组11例、第二组肝质地密集组15例、第三组肝质地无改变组5例;产前的三组患者分别为9/19例、9/19例、1/19例,产后的三组患者分别为2/12例、6/12例、4/12例,产前、产后比较,其第一、第三组病例数有显著差异(P<0.05)。三组患者的超声表现与黄疸情况无关,无轻度黄疸,重度、中度黄疸无显著差异。伴随腹部其他脏器受损,胆囊改变发生率最高,最常见的胆囊改变为胆囊壁水肿伴无胆汁或胆汁充盈差;有胰腺肿大伴胰周积液者2例提示病情危重,均为产前,其中1例死于该病的稀有并发症呼吸衰竭;产后脾肿大、胸腹腔积液较产前多。结论:AFLP腹部超声有其特点,可为临床诊治和预后提供帮助。
Objective: To investigate the characteristics of abdominal ultrasound in pregnant women with acute fatty liver during pregnancy. MATERIALS AND METHODS: The data of 31 AFLP patients, abdominal ultrasound and serum total bilirubin were collected from Shanghai Public Health Clinical Center. Results: According to the three manifestations of liver ultrasound, they were divided into three groups: 11 cases in the first group with fatty liver, 15 cases in the second group with dense liver mass and 5 cases in the third group with no change in liver quality. Respectively, 9/19 cases, 9/19 cases, 1/19 cases, postpartum three groups of patients were 2/12 cases, 6/12 cases, 4/12 cases, prenatal and postnatal comparison, the first, the first There were significant differences among the three groups (P <0.05). Three groups of patients with ultrasound performance and jaundice has nothing to do, no mild jaundice, severe, moderate jaundice no significant difference. Accompanied by other abdominal organs damage, the highest incidence of gallbladder changes, the most common gallbladder changes to gallbladder wall edema with no bile or poor bile filling; have pancreatic enlargement with peripancreatic fluid in 2 cases prompted the critical condition, are prenatal , Of which 1 died of rare complications of the disease respiratory failure; postpartum splenomegaly, pleural effusion more than prenatal. Conclusion: AFLP abdominal ultrasound has its own characteristics, which can help clinical diagnosis and prognosis.