妊娠合并血小板减少的病因及诊断

The Ginical Analysis of Thrombocytopenia During Gestation

目的:探讨妊娠期血小板减少的原因及临床处理对策。方法:回顾性分析我院1993-2003年间91例妊娠合并血小板减少患者的临床资料。结果:妊娠期血小板减少的患者占同期分娩产妇总数的5.78％,其中64.8％为妊娠期血小板减少(GT),14.3％为妊娠高血压综合征(PIH),特发性血小板减少性紫癜(ITP)占13.2％。其中GT组不需要特别处理,PIH组以皮质激素及输血小板为主,ITP组以皮质激素或免疫球蛋白(IVIG)为主。血小板低于20×109/L时输注血小板。全部病例无孕产妇死亡,新生儿血小板减少3例。结论:妊娠期血小板减少原因较多,应依据不同病情进行不同处理。

Objective: The cause and diagnosis of thrombocytopenia during pregnant were analyzed. Methods: 91 cases with thrombocytopenia during pregnant from 1993 to 2003 were investigated. Results: The rate of thrombocytopenia during pregnant were 5.78% .Among all of cases,64.8% of the cases are gestational thrombocytopenia (GT) ,14.3% is pregnancy-induced hypertension(PIH) ,and the proportion of idiopathic thrombocytopenia purpura (ITP) is 13. 2%, no special treatment is necessary for the patients who have GT. Prednisone and pleatelet are primary treatmeut for the patients who have PIH.For ITP,the prednisone of intravenous immunoglobulin (IVIG)is priority. The transfusion of platelet was necessary for the patients with platelet not more than 20 × 109/L. Therefore, for the all cases, maternal death was not occurred, thrombocytopenia in neonate was not observed. Conclusion: There are many causes to for thrombocytopenia during gestation; so the treatment should be taken to fit the state of patients .