摘要
目的:探讨妊娠期肝内胆汁淤积症(ICP)合并妊娠期高血压疾病(HDP)患者凝血功能、血流动力学变化及其母婴结局。方法:回顾性收集2019年6月-2023年6月本院收治的ICP产妇(ICP组)、ICP合并HDP产妇(ICP合并HDP组)、健康产妇(对照组)各60例临床资料,分析各组凝血指标与血流动力学指标变化,统计其母婴结局。结果:对照组、ICP组、ICP合并HDP组血清凝血酶原时间(12.19±1.39s、11.18±1.05s、10.62±1.22s),凝血酶时间(16.15±0.72s、15.24±0.66s、13.12±0.62s)、活化部分凝血酶时间(35.37±4.18s、32.05±3.27s、30.40±3.04s)依次降低,纤维蛋白原(4.15±0.45g/L、4.58±0.52g/L、4.98±0.61g/L)、脐动脉阻力指数、搏动指数及收缩期峰值流速与舒张末期血流速度比值依次升高,分娩孕周(39.3±1.6周、38.4±1.7周、38.0±1.4周)依次降低,剖宫产及羊水污染II度以上发生率依次升高,早产(1.7%、15.0%、18.3%)、低体重儿(0、6.7%、10.0%)、新生儿窒息(0、10.0%、13.3%)发生率依次升高(均P<0.05),但3组胎死宫内发生率未见差异(P>0.05)。结论:ICP合并HDP患者凝血功能与血流动力学变化显著,可影响母婴结局,密切监测相关指标对临床改善母婴结局等具有重要意义。
Objective:To investigate the changes of coagulation function and hemodynamics,and the maternal-neonatal outcomes of pregnant women with intrahepatic cholestasis of pregnancy(ICP)complicated with hypertensive disorder complicating pregnancy(HDP).Methods:The clinical data of 60 pregnant women with ICP in group A,60 pregnant women with ICP complicated with HDP in group B and 60 healthy pregnant women in group C from June 2019 to June 2023 were collected retrospectively.The changes of coagulation function and hemodynamics of the women in the three groups were analyzed.The maternal-neonatal outcomes of the women in the three groups were counted.Results:The serum prothrombin time(12.19±1.39s,11.18±1.05s and 10.62±1.22s),the thrombin time(16.15±0.72s,15.24±0.66s and 13.12±0.62s),and the activated partial thromboplastin time(26.37±4.18s,25.06±3.27s and 23.41±3.05 s)of the women in group C,in group A and in group B had decreased gradually.The fibrinogen level(4.15±0.45 g/L,4.58±0.52 g/L,4.98±0.61 g/L),the values of umbilical artery resistance index,pulsatility index and the ratio of the peak systolic velocity to the end diastolic velocity of the women in group C,in group A and in group B had increased gradually.The delivery gestational weeks(39.3±1.6 weeks,38.4±1.7 weeks and 38.0±1.4 weeks)of the women in group C,in group A and in group B had decreased gradually.The incidences of cesarean section and amniotic fluid con-tamination above gradeⅡof the women in group C,in group A and in group B had increased gradually.The incidences of the preterm birth(1.7%,15.0%and 18.3%),the low birth weight(O,6.7%and 10.0%)and the neonatal asphyxia(0,10.0%and 13.3%)of the women in group C,in group A and in group B had increased gradually(all P<0.05).There was no significant difference in the incidence of intrauterine fetal death of the women among the three groups(P>0.05).Conclusion:The coagulation function and hemodynamic indicators of the pregnant women with ICP complicated with HDP have changed significantly,which can influence the maternal-neonatal outcomes.The close mo-nitoring the relevant indicators is of great significance for improving the maternal neonatal outcomes.
作者
吴克乐
肖文雅
WU Kele;XIAO Wenya(The Second Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang Province,325000)
出处
《中国计划生育学杂志》
2024年第2期427-430,435,共5页
Chinese Journal of Family Planning
基金
温州市级科技计划项目(Y2023517)。
关键词
妊娠期肝内胆汁淤积症
妊娠期高血压
凝血功能
血流动力学
母婴结局
Intrahepatic cholestasis of pregnancy
Hypertensive disorder complicating pregnancy
Coagulation function
Hemodynamic
Maternal-neonatal outcomes
