不同程度妊娠期血小板减少症患者凝血功能、分娩方式及新生儿结局  

Coagulation function,delivery mode,and neonatal outcomes of pregnant women with different seriousness of gestational thrombocytopenia

作　　者：符以娟 吴海玲 张雯瑶 张晓蕾 FU Yijuan;WU Hailing;ZHANG Wenyeo;ZHANG Xisolei(Danzhou People's Hospital,Hainan Province,571700)

机构地区：[1]海南省儋州市人民医院,571700

出　　处：《中国计划生育学杂志》2023年第4期884-888,共5页Chinese Journal of Family Planning

摘　　要：目的:分析不同程度妊娠期血小板减少症(GT)对患者凝血功能、分娩方式和新生儿结局的影响。方法:选择2019年1月-2021年1月在本院分娩的GT孕妇120例临床资料,根据血小板计数(PLT)水平分为A组(PLT≤20×10^(9)/L)35例,B组(20×10^(9)/L<PLT<50×10^(9)/L)42例和C组(50×10^(9)/L≤PLT<100×10^(9)/L)43例,同期健康孕妇45例为对照组。比较各组凝血功能指标、分娩方式及新生儿结局情况。结果:A组、B组、C组PLT依次升高但均低于对照组,平均血小板体积(MPV)、血小板分布宽度(PDW)依次降低但均高于对照组(P均<0.05),4组凝血指标凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)均无差异(P>0.05)。A组、B组、C组剖宫产率(62.9%、45.2%、34.9%)依次降低但高于对照组(26.7%),产后出血发生率(34.3%、14.3%、7.0%)依次降低但均高于对照组(2.2%)(P<0.05),4组新生儿出生体重、新生儿窒息发生率无差异(P>0.05);A组、B组、C组早产率(45.7%、21.4%、18.6%)、新生儿血小板减少发生率(51.4%、28.6%、16.3%)均高于对照组(4.4%、4.4%)(P<0.05)。结论:不同程度GT孕妇PLT、MPV、PDW水平存在差异,但对凝血功能影响较小;GT病情越重越易增加剖宫产、产后出血及早产、新生儿血小板减少等不良结局,临床上应加强GT孕妇孕期管理,降低不良妊娠结局风险。Obective:To analyze the influence of dfferent seriousness of gestational thrombocyuopenia(GT)of preg-nant women on their coagulation function.delivery mode.and neonatal outcomes.Methods:The clinical data of 120 pregnant women with GT were selected in this study.The women were divided into group A(35 cases with platelet count≤20×10^(9)/L).group B(42 cases with 20×10^(9)/L<platelet count<50×10^(9)/L).and groupC(43 cases with 50×10^(9)/L≤platelet count<100×10^(9)/L)according to their PLT level.45 healthy pregnant women were selected in control group during the same period.The coagulation function index level.delivery mode,and neonatal outcomes of the women were compared among the four groups.Results:The platelet count of the women in group A.group B.and group C had increased gradually.and which was significantly lower than that of the women in the control group.The mean platelet volume(MPV)and platelet distribution width(PDW)of the women in group A,group B.and group c had decreased gradually.and which were all signifiantly higher than those of the women in the control group(P<0.05).There were no significant differences in the elotting indexes.such as prothrombin time(PT),thrombin time(TT),sctivated partial thrombin time(APTT),and fibrinogen(FIB),of the women among the four groups(P>0.05).The rate of cesarean section of the women in group A(62.9%).group B(45.2%).and group C(34.9%)had decreased gradually.and which was significantly higher than that(26.7%)of the women in the control group.The in-eidence of postpartum bemorrhage of the women in group A(34.3%),group B(14.3%),and group C(7.0%)had decreased gradully,and which was significanly higher than that(2.2%)of the women in the control group(P<0.05),there were no significant differences in the birth weight and the incidence of neonatal asplhyxia among the four groups(P>0.05).The preterm birth rate and the incidence of neonatal thrombocytopenia of the women in group A(45.7%and 51.4%),in groupB(21.4%and 28.6%),and in group C(18.6%and 16.3%)were significantly h

关 键 词：妊娠期血小板减少症 凝血功能 分娩方式 新生儿结局 

分 类 号：R714.254[医药卫生—妇产科学]