妊娠合并血小板减少157例临床分析

Clinical analysis of 157 patients with thrombocytopenia in pregnancy

目的探讨妊娠合并血小板减少症的发病机制及围生期处理。方法对157例妊娠合并血小板减少患者的临床资料作回顾性研究。结果孕妇相关性血小板减少症(PAT)120例,特发性血小板减少性紫癜(ITP)15例,重度妊娠高血压综合征／先兆子痫(PIH)12例,肝病5例,系统性红斑狼疮(SLE)2例,病毒感染3例,剖宫产93例,占59．2％,阴道分娩64例,占(40．8)％,PAT和PIH患者产后42d血小板较产前差异均有显著性(P<0.05)。新生儿1例血小板为96×109/L,2例出现头皮血肿,其余血小板均正常。产后42d共有136例患者血小板恢复正常,8例ITP、1例SLE、1例肝病患者3个月后血小板仍未恢复正常。结论妊娠合并血小板减少症一般发生在妊娠晚期,以PAT最常见,孕期注意观察及给予相应治疗,产前适当提高血小板水平,可以减少并发症的发生。

Objective To analyse the pathogenesis and the optinal management of pregnant women withthrombocytopenia.Methods 157 cases who admitted to our hospital during 2005 and 2006 retrospectively were studied.Results Among 157cases, pregnancy - associated thrombocy-topennia( PAT) 120 cases, autoimmune thrombocytopeniaC FTP) 15 cases, pregnancy induced hypertension /preeclampsia 12 cases, hepatic desease 5 cases, systemic lupus erythematosus 2 cases, viral infection 3 cases, there were 93 cases of C.S. (59.2%) and 64 cases of vaginal delivery (40.8%) .The platelet count of PAT patients and PIH patients were different after delivery,they all differ much( P < 0.05).The PLT were all normal besides 1 newborn. 1 newborn suffered from cephalohematoma. 136 patients resumed 42 days after delivery.Conclusion pregnancy thrombo-cytopenia usually becomes evident in the third trimester, PAT is the most common type of throm-bocytopenia during pregnancy, patients should be observed and received therapy. The PLT concentration should be raised before delivery.The complication could be less.