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目的探讨妊娠合并重度肝炎产前内科保守治疗的效果。方法回顾2002~2007年60例妊娠合并重度肝炎资料,对比入院时、入院后1、2、3周时的肝功能及凝血功能变化,方法采用配对资料的t检验。观察患者转归、治愈率、住院时间以及产科并发症。结果治疗1周后谷草转氨酶、谷丙转氨酶、血清白蛋白变化不明显,血清胆碱酯酶、凝血酶原活动度下降,血清总胆红素上升;治疗2周后谷草转氨酶、谷丙转氨酶下降,血清白蛋白、血清胆碱酯酶、凝血酶原活动度上升,血清总胆红素变化不明显,治疗3周后,全部指标均提示病情好转。总治愈率为95%(57/60)。无死亡病例。住院总时间为(22.3±3.3)d。21例患者出现先兆早产,10例患者出现胎儿窘迫,治疗后好转。结论对于大多数妊娠合并重度肝炎患者,在严密监护下进行内科治疗是可行的。
Objective To investigate the effect of prenatal medical conservative treatment of pregnancy complicated with severe hepatitis. Methods The data of 60 patients with severe hepatitis during pregnancy from 2002 to 2007 were retrospectively analyzed. The changes of liver function and coagulation function at admission, at 1, 2, and 3 weeks after admission were compared. The data were analyzed by t-test. Observe the outcome of patients, the cure rate, hospital stay and obstetric complications. Results Aspartate aminotransferase, alanine aminotransferase, and serum albumin did not change significantly after 1 week of treatment. The activities of serum cholinesterase and prothrombin decreased, and the serum total bilirubin increased. After 2 weeks of treatment, aspartate aminotransferase and alanine aminotransferase decreased , Serum albumin, serum cholinesterase, prothrombin activity increased, serum total bilirubin did not change significantly, after 3 weeks of treatment, all the indicators are prompted to improve. The overall cure rate was 95% (57/60). No deaths. The total hospital stay was (22.3 ± 3.3) days. Twenty-one patients had threatened preterm delivery, 10 had fetal distress, and improved after treatment. Conclusion For the majority of patients with severe hepatitis complicated by pregnancy, medical treatment under close supervision is feasible.