妊娠期肝脏疾病的鉴别诊断方法
- Authors
- Yannick Bacq, MD
Yannick Bacq, MD
- Praticien Hospitalier, Liver Unit
- Hopital Trousseau, University Hospital Center of Tours, Tours, France
- Richard H Lee, MD
Richard H Lee, MD
- Assistant Professor of Clinical Obstetrics and Gynecology
- Division of Maternal Fetal Medicine
- Keck School of Medicine of the University of Southern California
- Section Editors
- Keith D Lindor, MD
Keith D Lindor, MD
- Section Editor — Alcoholic and Metabolic Liver Disease
- Professor of Medicine, Mayo Clinic College of Medicine
- Dean, College of Health Solutions
- Arizona State University
- Charles J Lockwood, MD, MHCM
Charles J Lockwood, MD, MHCM
- Section Editor — Obstetrics
- Senior Vice President, USF Health
- Dean, Morsani College of Medicine
- Professor, Obstetrics and Gynecology
- University of South Florida
- Deputy Editors
- Anne C Travis, MD, MSc, FACG, AGAF
Anne C Travis, MD, MSc, FACG, AGAF
- Deputy Editor — Gastroenterology/Hepatology
- Assistant Professor of Medicine, Part-time
- Harvard Medical School
- Vanessa A Barss, MD, FACOG
Vanessa A Barss, MD, FACOG
- Senior Deputy Editor — UpToDate
- Deputy Editor — Obstetrics, Gynecology and Women's Health
- Associate Clinical Professor of Obstetrics, Gynecology and Reproductive Biology
- Harvard Medical School
- Translators
- 贾双征, 住院医师
贾双征, 住院医师
- 北京协和医院妇产科
引言
妊娠妇女发生肝胆疾病是会诊临床医生面临的一项挑战。妊娠期发生的肝脏异常需要在妊娠预期的生理变化背景下做出诊断。此外，诊断性和治疗性决策必须考虑到对母亲及胎儿的影响。
妊娠期肝胆疾病的类型和表现不同。
●一些肝脏疾病或有肝脏表现的多系统性疾病是妊娠期特有的。前者的例子有妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy, ICP)和妊娠期急性脂肪肝(acute fatty liver of pregnancy, AFLP)；后者的例子有妊娠剧吐和子痫前期，并且可能并发溶血、肝酶升高和血小板降低(hemolysis, elevated liver enzymes, and low platelets, HELLP)综合征。(参见相关专题)。
●妊娠相关的生理性变化可能会增加同样可发生于非妊娠妇女的肝胆疾病的严重程度，或使之易患此类肝胆疾病。示例包括：胆石症、血栓性疾病(如巴德-吉亚利综合征)和戊型肝炎病毒感染。(参见“妊娠期间发生的肝胆疾病”)
●一些疾病与妊娠无关，但可首现于妊娠期(如，急性病毒性肝炎)。(参见“妊娠期间发生的肝胆疾病”)
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To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:Literature review current through: 2017-06 . | This topic last updated: 2017-02-09.The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.References- Riely CA. Liver disease in the pregnant patient. American College of Gastroenterology. Am J Gastroenterol 1999; 94:1728.
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