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目的:探讨妊娠期急性脂肪肝的临床特点、早期诊断与治疗,以期改善孕产妇及围产儿的预后。方法:回顾性分析5例妊娠期急性脂肪肝患者的临床资料。结果:5例患者均于孕晚期出现不同程度消化道症状,主要表现为恶心、呕吐,2例出现皮肤黄染,并伴凝血功能障碍、肝肾功能损伤、低血糖及多脏器功能衰竭等;实验室检查可见血清转氨酶、胆红素升高,血小板下降,凝血酶原时间、活化部分凝血活酶时间延长,纤维蛋白原降低,低血糖等特征。结论:重视妊娠晚期无诱因的消化道症状,及时进行血清转氨酶及胆红素等实验室检查,早期诊断、尽快终止妊娠有利于改善孕产妇及围产儿预后。
Objective: To investigate the clinical features, early diagnosis and treatment of acute fatty liver during pregnancy in order to improve the prognosis of pregnant women and perinatal children. Methods: The clinical data of 5 patients with acute fatty liver during pregnancy were retrospectively analyzed. Results: All five patients showed different degrees of gastrointestinal symptoms in the third trimester. The main symptoms were nausea and vomiting, skin yellowing in 2 cases, coagulation dysfunction, liver and kidney dysfunction, hypoglycemia and multiple organ failure Laboratory tests showed elevated levels of serum aminotransferases, bilirubin, platelets, prothrombin time, prolonged partial thromboplastin time, decreased fibrinogen, and hypoglycemia. Conclusion: It is important to pay attention to the digestive symptoms without inducing in the third trimester of pregnancy and carry out the laboratory tests such as serum transaminase and bilirubin in time. Early diagnosis and termination of pregnancy as soon as possible are helpful to improve the prognosis of pregnant women and perinatals.