目的 分析双胎合并妊娠期肝内胆汁淤积症的临床特点.方法 我院产科诊治的双胎妊娠患者515例,其中双胎妊娠合并妊娠期肝内胆汁淤积症17例为观察组,随机选取18例未合并肝内胆汁淤积症的双胎妊娠患者为对照组.观察并比较两组患者围生儿预后情况、孕妇生产方式及并发症发生情况.结果 双胎妊娠合并妊娠期肝内胆汁淤积症的发病率为3.30％；观察组中发生胎儿窘迫、胎儿窒息及胎儿死亡的比例分别为41.2％、52.9％和35.3％,显著高于对照组的5.6％、11.1％和0(P＜ 0.05)；观察组患者中剖宫产比例为70.6％,显著高于对照组的33.3％(P＜0.05)；观察组患者发生妊高症及产后出血并发症的比例分别为58.8％和41.2％,均明显高于对照组的16.7％和5.6％(P＜0.05).结论 双胎妊娠合并妊娠期肝内胆汁淤积症发病率高,胎儿预后较差,孕妇并发症多,临床工作中应该积极应对.%Objective To analyze the clinical characteristics of the twin pregnancy with intrahepatic cholestasis. Methods Five hundred and fifteen patients of twin pregnancy were chosen. Seventeen of the patients complicated with intrahepatic cholestasis were chosen as the study group, and 18 of the patients without intrahepatic cholestasis were chosen as the control group. The prognosis, maternal mode of production and occurrence of complications were compared between the two groups. Results The incidence of twin pregnancy complicated with gestational intrahepatic cholestasis were 3.30%. The occurrence of fetal distress, fetal asphyxia and fetal death in the study group were 41.2%, 52.9% and 35.3%, respectively, significantly higher than those in the control group (5.6%, 11.1% and 0%, respectively), P<0.05. The incidence of cesarean section, the pregnancy induced hypertension and postpartum hemorrhage of the study group were 70.6%, 58.8% and 41.2%, respectively, significantly higher than those in the control (33.3%, 16.7% and 5.6%, respectively), P<0.05. Conclusion Twin pregnancy is characterized by a high incidence of intrahepatic cholestasis syndrome, with poor fetal prognosis, more pregnant complications, which should be paid special attention to.
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