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[妊娠急性脂肪肝。高尿酸血症在黄疸前期的诊断价值]

[Acute fatty liver of pregnancy. Diagnostic value of hyperuricemia in the pre-jaundice stage].

作者信息

Hsiung R, Hasselmann M, Lutun P, Gordji M

机构信息

hervice de Gynécologie-Obsterique, Hospitalor, Forback.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 1988;17(7):901-5.

PMID:3221052
Abstract

Acute fatty liver of pregnancy, with a case history where an early diagnosis could have been made, and a review of the French literature. Acute fatty liver of pregnancy, or Sheehan's syndrome is a rare but very serious complication of pregnancy. The disease is demonstrated by vomiting, abdominal pain and a high level of uric acid in the blood before jaundice is noted. Within a few days the triad of jaundice, pruritus and encephalopathy occur. These are often associated with toxaemia of pregnancy and with polyuria and polydipsia. A raised white blood count and a high level of bilirubinemia are almost always present. The outlook is very serious when haemorrhage appears. This malignant form of the disease is characterised by liver and kidney failure. Liver biopsy confirms the diagnosis. The prognosis is related to an early diagnosis and is good when labour is induced or caesarean section performed. Acute fatty liver of pregnancy is an emergency from the diagnostic as well as the therapeutic angles.

摘要

妊娠急性脂肪肝,附一例本可早期诊断的病史及法国文献综述。妊娠急性脂肪肝,或希恩综合征是一种罕见但非常严重的妊娠并发症。在出现黄疸之前,该病表现为呕吐、腹痛和血液中尿酸水平升高。几天内会出现黄疸、瘙痒和脑病三联征。这些症状常与妊娠中毒症以及多尿和烦渴有关。几乎总会出现白细胞计数升高和高胆红素血症。出现出血时,预后非常严重。这种恶性疾病形式的特征是肝肾功能衰竭。肝活检可确诊。预后与早期诊断有关,引产或剖宫产时预后良好。从诊断和治疗角度来看,妊娠急性脂肪肝都是一种急症。

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