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目的:探讨妊娠期急性脂肪肝的高危因素、临床特点、诊治及母婴预后。方法:回顾性分析妊娠急性脂肪肝的临床特点。结果:18例患者早期均存在消化道症状,其中出现呕吐16例,1周左右出现黄疸并进行性加重15例,合并严重的凝血功能障碍,产后大出血12例,行介入下子宫动脉栓塞术10例,行子宫全切除术4例,合并急性肾功能衰竭5例,患者因多器官功能衰竭死亡4例。新生儿存活17例,死亡4例。结论:妊娠急性脂肪肝早期以消化道症状为主,病情进展快、危重,尽量早期确诊,及时终止妊娠,并予器官功能支持治疗。
Objective: To investigate the risk factors of acute fatty liver in pregnancy, clinical features, diagnosis and treatment of maternal and child prognosis. Methods: The clinical features of acute fatty liver in pregnancy were analyzed retrospectively. Results: Eighteen patients had digestive symptoms in the early stage, including 16 cases of vomiting, jaundice in one week and 15 cases of progressive aggravating. With severe coagulation dysfunction, 12 cases of postpartum hemorrhage and interventional uterine arterial embolization Cases, 4 cases of hysterectomy, acute renal failure in 5 cases, patients died of multiple organ failure in 4 cases. Neonatal survival in 17 cases, 4 deaths. Conclusion: The early stage of acute fatty liver in pregnancy is characterized by gastrointestinal symptoms. The disease progresses rapidly and critically. Early diagnosis is possible. Pregnancy termination is timely and organ function supportive therapy is provided.