论文部分内容阅读
目的探讨妊娠肝内胆汁淤积综合征孕妇所娩新生儿发生肺损伤的危险因素。方法将我院妇产科诊断妊娠期肝内胆汁淤积症的产妇及其新生儿30例(ICP组)与同期正常分娩之孕妇及新生儿40例(对照组)列为研究对象,分析新生儿发生肺损伤的发病率及临床特点,比较母亲血清和羊水中总胆汁酸、甘胆酸及其与新生儿肺损伤之间的关系。结果 ICP组新生儿肺损伤发病率增加,新生儿肺损伤以暂时性呼吸过快、新生儿肺炎及新生儿呼吸窘迫综合征为主要类型;孕妇血清与羊水甘胆酸水平在一定范围内相关,且与新生儿肺损伤发病率相关性较好。血清甘胆酸上升至40μg/ml,或当血清总胆汁酸上升至30μmol/L时,羊水甘胆酸及总胆汁酸异常率超过75%,此时新生儿发生肺损伤的概率明显增加。结论母亲患妊娠肝内胆汁淤积综合征可增加新生儿肺损伤的发病机会,母亲血清及羊水中高胆酸(甘胆酸)水平可能是导致新生儿肺损伤的原因。
Objective To investigate the risk factors of lung injury in neonates born to pregnant women with intrahepatic cholestasis of pregnancy. Methods The obstetric and gynecological diagnosis of intrahepatic cholestasis of pregnancy in 30 pregnant women and their newborns (ICP group) and the normal delivery of pregnant women and newborns in the same period 40 cases (control group) as a research object, analysis of newborns Incidence of lung injury and clinical features of the comparison of maternal serum and amniotic fluid total bile acid, glycocholate and neonatal lung injury and the relationship between. Results The incidence of neonatal lung injury was increased in ICP group. The neonatal lung injury was mainly characterized by transient hyperventilation, neonatal pneumonia and neonatal respiratory distress syndrome. The serum level of pregnant women was correlated with the level of amniocholytic acid, And neonatal lung injury incidence was good. Serum glycocholate increased to 40μg / ml, or when the total serum bile acid increased to 30μmol / L, the abnormal rate of amniocholoic acid and total bile acid more than 75%, then the probability of neonatal lung injury increased significantly. Conclusion Maternal pregnancy induced intrahepatic cholestasis syndrome can increase the incidence of neonatal lung injury. Maternal serum and amniotic fluid levels of cholic acid (glycocholate) may be the cause of neonatal lung injury.