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目的探讨妊娠期急性脂肪肝(AFLP)的临床特点。方法对北京佑安医院2008年5月至2013年11月收治的38例AFLP患者的临床资料进行回顾性分析,包括临床特征、实验室检查和治疗、转归情况。结果 38例患者在发病前1~2周均出现不同程度乏力、不适症状,38例均有肝功能障碍,18例肝肾功能衰竭,死亡4例(10.5%),围产儿死亡3例(7.3%)。结论妊娠期急性脂肪肝起病急、病情凶险,应早期诊断治疗、及时终止妊娠,AFLP患者发生产后出血和多脏器功能不全的比例较高,应严密监测及调节凝血功能、肝肾功能,血浆置换治疗可有效降低母体病死率。
Objective To investigate the clinical features of acute fatty liver during pregnancy (AFLP). Methods The clinical data of 38 patients with AFLP admitted to Beijing You’an Hospital from May 2008 to November 2013 were retrospectively analyzed, including clinical features, laboratory tests, treatment and outcome. Results Thirty-eight patients had varying degrees of fatigue and discomfort 1 to 2 weeks before onset of symptoms. All of the 38 patients had liver dysfunction, 18 patients had liver and kidney failure, 4 patients died (10.5%), 3 were perinatal deaths (7.3) %). Conclusion The incidence of acute fatty liver during pregnancy is very high and the disease is dangerous. Early diagnosis and treatment should be performed and the pregnancy should be stopped promptly. The incidence of postpartum hemorrhage and multiple organ dysfunction in AFLP patients is relatively high. Coagulation, liver and kidney function, Plasma exchange therapy can effectively reduce maternal mortality.