妊娠合并血小板减少的临床特点及妊娠结局  

Clinical characteristics and pregnancy outcomes of pregnant women with thrombocytopenia

作　　者：秦珂琳 赵先兰[1] Qin Kelin;Zhao Xianlan(Department of Obstetrics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000)

机构地区：[1]郑州大学第一附属医院产科,郑州450000

出　　处：《现代妇产科进展》2023年第1期35-38,42,共5页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨妊娠合并血小板减少患者的临床特点及母婴结局,为改善其不良妊娠结局提供科学依据。方法:收集2019年10月至2022年3月于郑州大学第一附属医院产科分娩的272例妊娠合并血小板减少患者的临床资料,按血小板减少程度分为轻度组119例、中度组70例、重度组83例,比较各组的临床特点及母婴结局。结果:患者存在多种内外科合并症及妊娠并发症。3组患者的孕次、产次、体质量指数比较,差异无统计学意义(P>0.05),重度组的年龄较其他两组小,多同时存在血小板减少病史(P<0.05)。轻度组的入院血小板计数、血小板压积和血红蛋白值最高,中度组次之,重度组最低(P<0.001)。重度组的剖宫产、贫血、住院期间输血小板占比最高(P<0.001),3组产后出血比较差异无统计学意义(P=0.277)。3组的新生儿出生时Apgar评分、窒息方面差异无统计学意义(P>0.05),但重度组的入院时孕周小,新生儿出生体重低,早产、新生儿转NICU比例高(P<0.001)。结论:妊娠合并轻度血小板减少对母婴几乎无不良影响,合并重度血小板减少可能增加不良妊娠结局发生率,临床要结合血小板计数和产科指征以及医院救治水平进行综合判断处理。Objective:To examine the clinical characteristics and pregnancy outcomes of pregnant patients with thrombocytopenia,and to provide scientific basis for improving the adverse outcomes of pregnant women and infants.Methods:A total of 272 pregnant women with thrombocytopenia who were treated in the the obstetrics department of the First Affiliated Hospital of Zhengzhou University from October 2019 to March 2022 were selected.According to the degree of thrombocytopenia,they were devided into mild group(119 cases),moderate group(70 cases)and severe group(83 cases).The clinical characteristics and pregnancy outcomes of each groups were compared.Results:The pregnant patients had multiple medical and surgical diseases or pregnancy complications.There was no significant differences in pregnancy times,birth times and body mass index among three groups(P>0.05).However,the patients in the severe group were younger than the other two groups and most of them had a history of thrombocytopenia(P≤0.001).The admission platelet count,plateletcrit and hemoglobin value in the mild group were the highest,followed by the moderate group,and the lowest in the severe group(P<0.001).The rates of cesarean section,anemia and platelet transfusion during hospitalization in the severe group were the highest(P<0.001),but there was no significant difference in postpartum hemorrhage among three groups(P=0.277).The Apgar score and neonatal asphyxia were comparable between all groups(P>0.05).Compared with the mild to moderate group,the severe group in admission gestational week was earlier,the neonatal weight was lower,the proportions of premature delivery and neonatal transfer to NICU were higher(P<0.001).Conclusion:Mild thrombocytopenia has almost no adverse effects on mothers and infants.Severe thrombocytopenia may increase the incidence of adverse pregnancy outcomes.Clinical diagnosis and treatment should be combined with maternal platelet count,obstetric indications and hospital treatment level.

关 键 词：妊娠合并血小板减少 程度 临床特点 母婴结局 

分 类 号：R714.2[医药卫生—妇产科学]