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目的总结应用中西医结合治疗妊娠期肝内胆汁淤积症(ICP)的疗效及其对围生儿的影响。方法住院ICP患者72例,经西药保肝、降酶、利胆和口服中药茵陈汤治疗,同时加强孕期监护;观察孕妇ICP症状的改变,记录围生儿结局。结果 72例患者治疗7～10d后复查,84.7%患者胆汁酸明显下降,81.9%转氨酶(AST,ALT)下降明显至正常,90.3%皮肤瘙痒症状明显好转至消失;对胆汁酸和转氨酶下降或症状改善不明显者,继用一疗程后基本恢复正常。2例孕龄大于36周,NST无反应型,已予地塞米松促胎肺成熟,即行剖宫产术,母婴术后恢复良好,无一例围生儿死亡。结论中西医结合治疗ICP,同时加强胎心监护,可明显降低围生儿病死率,减轻孕妇的自觉症状及肝损表现。
Objective To summarize the curative effect of integrative medicine on intrahepatic cholestasis of pregnancy (ICP) and its effect on perinatal children. Methods 72 cases of hospitalized patients with ICP were treated with Western medicine of protecting liver, reducing enzyme, gallbladder and orally taking traditional Chinese medicine Yinchen Decoction. At the same time, the monitoring of pregnancy was strengthened. The changes of ICP symptoms in pregnant women were observed. The perinatal outcome was recorded. Results 72 patients were reviewed after 7-10 days, 84.7% patients had significantly decreased bile acid, 81.9% aminotransferase (AST, ALT) decreased significantly to normal, 90.3% pruritus symptoms were significantly improved to disappear; bile acid and aminotransferase decreased or symptoms Improvement is not obvious who, after a course of treatment returned to normal. 2 cases of gestational age greater than 36 weeks, NST nonresponders, dexamethasone to promote fetal lung maturity, that cesarean section, maternal and child postoperative recovery was good, without a perinatal death. Conclusion Integrative treatment of ICP, while strengthening fetal heart rate monitoring, can significantly reduce perinatal mortality, reduce symptoms of pregnant women and liver damage performance.