妊娠期肝内胆汁淤积症合并妊娠期糖尿病终止妊娠时机与围生结局分析(1)
[摘要] 目的 分析妊娠期肝内胆汁淤积症合并妊娠期糖尿病终止妊娠时机以及围生结局。 方法 回顾分析该院2013年11月—2018年11月收治的93例妊娠期肝内胆汁淤积症(ICP)合并妊娠期糖尿病(GDM)孕妇，将这些患者根据病情轻重情况划分为A组和B组，对两组患者实施相应的干预，然后根据患者糖尿病控制满意情况进行小组划分，比较两组干预处理之后终止妊娠时机以及围生结局。 结果A1和A2两组新生儿窒息以及孕妇出血量要高于B1和B2两组，但是几组围产儿死亡数据比较差异无统计学意义(P>0.05);而A1和A2两组孕妇实施剖宫产的概率要高于B1和B2两组，差异有统计学意义(P<0.05)，同时两组孕妇妊娠终止时间要短于B1和B2两组。 结论 对ICP合并GDM孕妇实施分类和个体化干预处理可以有效改善患者的肝功能，通过适时终止能够合理改善围产儿的结局。
[关键词] 糖尿病;肝功能;胎儿窘迫;围产儿死亡
[中图分类号] R714.7 [文献标识码] A [文章编号] 1672-4062(2019)08(a)-0038-02
[Abstract] Objective To analyze the timing and termination of pregnancy in intrahepatic cholestasis of pregnancy with gestational diabetes. Methods A retrospective analysis of 93 pregnant women with intrahepatic cholestasis of pregnancy (ICP) and gestational diabetes mellitus (GDM) admitted to our hospital from November 2013 to November 2018， these patients were divided into groups A and B according to the severity of the disease. In the group， the corresponding interventions were performed on the two groups of patients， and then the group was divided according to the patient's diabetes control satisfaction， and the timing of the termination of pregnancy and the perinatal outcome were compared after the two groups were treated. Results The neonatal asphyxia and maternal bleeding in the A1 and A2 groups were higher than those in the B1 and B2 groups， but there were no statistical differences in the perinatal mortality data between the two groups(P>0.05). The probability of cesarean section was higher in the A1 and A2 groups. In the B1 and B2 groups， the difference was statistically different(P<0.05)， and the termination time of the two groups of pregnant women was shorter than that of the B1 and B2 groups. Conclusion The classification and individualized intervention of ICP combined with GDM pregnant women can effectively improve the liver function of patients， and can reasonably improve the outcome of perinatal children by timely termination.
[Key words] Diabetes; Liver function; Fetal distress; Perinatal death
ICP和GDM是對围产儿结局造成影响的并发症，同时也是导致围产儿死亡的主要原因，需要对此实施分析和研究。ICP容易让孕妇出现自发性早产，同时伴随胎儿窘迫等问题，容易让胎儿出现生长受限的情况，这样就导致新生儿出现窒息甚至是死亡的情况，通常需要提前终止妊娠。而GDM的胎儿会出现延迟成熟的问题，会发生较高的NRDS，这样也会合理延后终止妊娠的时机[1]。如果ICP合并GDM则会增加产儿整体患病的概率，同时也伴随着较高的死亡概率，增加产科护理人员的工作难度，需要科学选择终止妊娠的时机，这是产科医生需要面临的研究课题。该次研究选择该院2013年11月—2018年11月收治的93例ICP合并GDM孕妇为研究对象，对这些临床资料实施分析和对此以探究终止妊娠时机对围产儿所造成的影响，希望可以对合理改善围生儿的结局提供更科学的临床依据，现报道如下。, 百拇医药(热依汗·吉力力)
[关键词] 糖尿病;肝功能;胎儿窘迫;围产儿死亡
[中图分类号] R714.7 [文献标识码] A [文章编号] 1672-4062(2019)08(a)-0038-02
[Abstract] Objective To analyze the timing and termination of pregnancy in intrahepatic cholestasis of pregnancy with gestational diabetes. Methods A retrospective analysis of 93 pregnant women with intrahepatic cholestasis of pregnancy (ICP) and gestational diabetes mellitus (GDM) admitted to our hospital from November 2013 to November 2018， these patients were divided into groups A and B according to the severity of the disease. In the group， the corresponding interventions were performed on the two groups of patients， and then the group was divided according to the patient's diabetes control satisfaction， and the timing of the termination of pregnancy and the perinatal outcome were compared after the two groups were treated. Results The neonatal asphyxia and maternal bleeding in the A1 and A2 groups were higher than those in the B1 and B2 groups， but there were no statistical differences in the perinatal mortality data between the two groups(P>0.05). The probability of cesarean section was higher in the A1 and A2 groups. In the B1 and B2 groups， the difference was statistically different(P<0.05)， and the termination time of the two groups of pregnant women was shorter than that of the B1 and B2 groups. Conclusion The classification and individualized intervention of ICP combined with GDM pregnant women can effectively improve the liver function of patients， and can reasonably improve the outcome of perinatal children by timely termination.
[Key words] Diabetes; Liver function; Fetal distress; Perinatal death
ICP和GDM是對围产儿结局造成影响的并发症，同时也是导致围产儿死亡的主要原因，需要对此实施分析和研究。ICP容易让孕妇出现自发性早产，同时伴随胎儿窘迫等问题，容易让胎儿出现生长受限的情况，这样就导致新生儿出现窒息甚至是死亡的情况，通常需要提前终止妊娠。而GDM的胎儿会出现延迟成熟的问题，会发生较高的NRDS，这样也会合理延后终止妊娠的时机[1]。如果ICP合并GDM则会增加产儿整体患病的概率，同时也伴随着较高的死亡概率，增加产科护理人员的工作难度，需要科学选择终止妊娠的时机，这是产科医生需要面临的研究课题。该次研究选择该院2013年11月—2018年11月收治的93例ICP合并GDM孕妇为研究对象，对这些临床资料实施分析和对此以探究终止妊娠时机对围产儿所造成的影响，希望可以对合理改善围生儿的结局提供更科学的临床依据，现报道如下。, 百拇医药(热依汗·吉力力)