重度妊娠期肝内胆汁淤积症合并HBV感染患者1例报告并文献复习

A Case Report of Severe Intrahepatic Cholestasis of Pregnancy Complicated with HBV Infection and Literature Review

摘要: 本文报告1例31岁孕34周初产妇病例。患者因“停经34周6天，发现肝功能异常4月余”急症入院，患者孕期产检未遵医嘱治疗，缺乏对该疾病的认识，肝功能控制欠佳，入院后总胆汁酸67.8 μmol/l，患者乙肝病史2年余，行急症剖宫产后转入ICU并行血浆置换。本文结合文献复习，探讨妊娠期肝内胆汁淤积症合并HBV感染的病因及治疗，旨在提高临床医生对该疾病的认识，指导围产期管理，并做好临床宣教工作。

Abstract: This paper reports a case of a 31-year-old pregnant woman at 34 weeks of gestation. The patient was admitted to the hospital due to “menopause for 34 weeks and 6 days, and abnormal liver function for more than 4 months”. The patient did not follow the doctor’s advice during pregnancy, lacked understanding of the disease, and the liver function was poorly controlled. After admission, the total bile acid was 67.8 μmol/l, and the patient had a history of hepatitis B for more than 2 years. After emergency cesarean section, he was transferred to ICU and plasma exchange was performed. Combined with literature review, this paper discusses the etiology and treatment of intrahepatic cholestasis of pregnancy complicated with HBV infection, aiming to improve clinicians’ understanding of the disease, guide perinatal management, and do a good job in clinical education.