妊娠合并血小板减少208例临床分析  

Clinical Analysis of 208 Pregnant Women Complicated with Thrombopenia

作　　者：蔡惠兰[1] 张吟雪[2] 秦洁[1] 

机构地区：[1]温州医学院附属第三医院,浙江温州325200 [2]温州医学院附属第一医院,浙江温州325000

出　　处：《实用妇产科杂志》2007年第6期363-365,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨妊娠合并血小板减少的病因及围生期的处理方法。方法:回顾性分析1996年1月至2005年12月收治的妊娠合并血小板减少患者208例临床资料。结果:208例孕妇中妊娠期血小板减少症(PAT)88例(42.31%),特发性血小板减少性紫癜(ITP)58例(27.88%),妊娠期高血压疾病32例(15.38%),系统性红斑狼疮12例(5.77%),再生障碍性贫血(AA)10例(4.81%),妊娠期肝内胆汁淤积症(ICP)2例(0.96%),血栓性血小板减少性紫癜(TTP)2例(0.96%),Evan’s综合征1例(0.48%),病因不明3例(1.44%)。结论:多种原因可引起妊娠期孕妇血小板减少,PAT是最常见类型。血小板<50×109/L,应在术前输注浓缩血小板后行剖宫产;血小板计数>50×109/L的孕妇,如无产科指征,应阴道分娩为主。Objective：To study the etiopathogenesis and the optimal management in pregnant women complicated with thrombocytopenia. Methods： 208 cases of pregnant women complicated with thrombocytopenia in our hospital from 1996 to 2005 were studied retrospectively. Results： Thrombocytopenia was mainly caused by pregnancy- associated thrombocytopenia （PAT） in 88 cases （42.31%）,idiopathic thrombocytopenia （ITP） in58 （27.88 %）, pregnancy induced hypertension （ PIH ） 32 （ 15.38 % ）, systematic lupus erythematosus （ SLE ） 12 （ 5.77 % ）, aregeneratory anemia（AA） 10（4.81%）, intrahepatic cholestasis of pregnancy（ICP） 2 （0.96%）, thrombotic thrombocytopenic purpura （TTP） 2（0.96%）, Evan＇s syndrome 1（0.48%）, and unknown 3（1.44%）.Conclusions： The reasons caused thrombocytopenia during pregnancy are diverse, PAT is the most common type. Caesarean delivery should be performed after infusion of piatelet concentrate in those piatelet 〈 50 × 10^9/L. In patients whose piatelet 〉 50 × 10^9/L, transvaginal delivery can be chosen if there is no obstetrical indication. It is significant to improve obstetrical quality with cooperating associated division, strengthening perinatal care, and treating actively primary disease.

关 键 词：妊娠 血小板减少 病因 妊娠结局 

分 类 号：R714.254[医药卫生—妇产科学]