妊娠合并血小板减少症35例临床分析  

A Clinical Analysis of 35 Thrombocytopenia in Pregnancy

作　　者：高谨[1] 毛熙光[1] 颜真淑[1] 

机构地区：[1]泸州医学院附属医院,四川泸州646000

出　　处：《实用妇产科杂志》2003年第3期161-162,共2页Journal of Practical Obstetrics and Gynecology

摘　　要：目的 :探讨妊娠合并血小板减少症 (PT)的病因及处理。方法 :回顾性分析 35例PT患者的诊断、治疗及新生儿结局。结果 :PT的病因主要包括妊娠相关性血小板减少症 (PAT)、免疫性血小板减少性紫癜 (ITP)及妊高征 /先兆子痫 /HELLP综合征。对血小板计数 <5 0× 10 9/L者在分娩前后应短期使用糖皮质激素及血小板制剂 ,分娩方式应由产科指征决定。产后出血率为 14 .2 8% ,产后出血量与血小板计数呈负相关 ,未发现新生儿出血。PAT患者在分娩后 2月内血小板计数恢复正常。结论 :PAT是最常见的妊娠合并血小板减少症类型 ,产时对母儿无明显危害。除了针对病因治疗外 ,糖皮质激素及血小板制剂是治疗严重PT的有效手段。Objective:To explore the causes and management of pregnant women with thrombocytopenia.Methods:Medical records from 1995 to 2001 were reviewed for diagnosis, treatment, and neonatal outcome in 35 women with thrombocytopenia.Results:Thrombocytopenia was mainly caused by pregnancy-associated thrombocytopenia (PAT), autoimmune thrombocytopenia (ITP) and pregnancy induced hypertension/preeclampsia/HELLP syndrome. Glucocorticoid and platelet transfusion were given to those with platelet count lessthen <50×10 9/L for a short period. The mode of delivery was determined by obstetric factors alone. The occurrence of postpartum hemorrage was 14.28%, the amount of hemorrhage was inversely correlated with platelet count. No neonatal bleeding occurred. PAT recovered spontaneously within 2 months after delivery. Conclusions:PAT is the most common type of thrombocytopenia during pregnancy and poses no apparent risk for mother or infant at delivery. Besides therapy directing at the etiology, glucocorticoid and platelet transfusion are effective treatment for severe thrombocytopenia during delivery.

关 键 词：妊娠 血小板减少症 出血 病因 糖皮质激素 血小板制剂 

分 类 号：R714.254[医药卫生—妇产科学]