妊娠合并血小板减少89例临床分析

Clinical analysis of 89 thrombocytopenia in pregnancy

目的探讨妊娠合并血小板减少的病因、治疗及分娩方式。方法回顾性分析我院2006年1月-2009年3月收治的89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主要病因有妊娠相关性血小板减少症（PAT）65例（73．03％），妊娠期高血压疾病（HDCP）11例（12．36％），特发性血小板减少性紫癜（ITP）6例（6．74％），妊娠合并肝脏疾病5例（5．61％），系统性红斑狼疮合并妊娠2例（2．24％）。PAT孕期不需特殊处理，妊娠结局良好，对血小板〈50×10^9／L的12例患者分娩前给予地塞米松10～20mg／d，5例无效者分娩时输注血小板。结论妊娠期血小板减少以PAT多见，孕期不需特殊处理。其次为妊娠期高血压疾病（HDCP）。当血小板≤50×10^9／L分娩前给予地塞米松治疗，静脉点滴3—5d，无效者分娩时输注血小板，分娩方式以剖宫产为宜，产后出血发生率12．35％。

Objective To explore the causes,therapy and the way of delive of pregnant women with thromboeytopenia. Methods The data of 89 cases with thrombocytopenia during pregnancy were reviewed from Jan. 2006 to Mar. 2009. Results The main cause of thrombocytopenia during pregnancy were pregnancy associated thrombocytopenia （PAT） has 65 cases （73.03%）, Hypertensive disorder complicating pregnancy（HDCP） has 11 cases（ 12. 36% ）. Idiopathic thromboeytopenia（ITP） has 6 cases（6.74% ）. Hepatic disease in pregnancy has 5 cases （5.61% ,Systemic lupus erythematosus in pregnancy has 2cases （2. 24% ）. Pregnancy associated thrombocytopenia need not to be specially treated during pregnancy, To the 12 patients whose platelet 〈50× 10^9/L given dexamethasone 10 -20mg/d treatment before delivery , But five patients who has no effect intravenous platelet treatment during delivery. Conclusion Pregnancy associated thrombocytopenia is the common reason in thrombocytopenia during pregnancy, Pregnancy associated thrombocytopenia need not to be specially treated during pregnancy. The second reason is hypertensive disorder complicating pregnancy, when their platelet is less than 50× 10^9/L are injected with dexamethasone 10 -20mg/d treatment before delivery, Intravenous drip for 3 -5 days, if the treatment is not effective,The patients should accept being injected with platelet and being abdominal delivery. The rate of postpartum hemorrhage is 12. 35%.