妊娠合并血小板减少42例临床分析

Clinical analysis for 42 cases of pregnancy with thrombocytopenia

目的:探讨妊娠合并血小板减少的病因和围生期处理。方法:在治疗原发病的基础上,血小板计数>50×109/L且无症状者,常规口服铁剂、肌酐、叶酸、维生素等;血小板<50×109/L者,终止妊娠前后短期使用糖皮质激素、血小板及免疫球蛋白,同时考虑剖宫产。结果:42例中单纯由妊娠引起血小板减少24例,子痫前期11例,特发性血小板减少性紫癜4例,合并肝脏疾病2例,再生障碍性贫血1例。42例中剖宫产19例,阴道分娩23例;产后出血3例,新生儿血小板减少1例。结论:多种原因可以导致妊娠妇女血小板减少,在针对病因治疗基础上,血小板制剂、糖皮质激素及免疫球蛋白是治疗严重妊娠合并血小板减少的有效手段。

Objective：To study the pathogenesis of thrombocytopenia and its optimal treatment in perinatal period. Methods：Based on the treatment of primary disease, platelet counts 〉 50×109/L and asymptomatic patients were given oral iron-supplementary, creatinine,folic acid and vitamins routinely. As for patients with platelet counts 〈 50 ×109/L, they were treated with glucocorticoid, platelet and immunoglobulin in periuatal period, and the caesarean section was considered. Results： The main causes of thrombocytopenia included pregnancy itself in 24 cases, preeelampsia in 11 cases, idiopathic thromboeytopenie purpura in 4 cases,liver diseases in 2 cases, and aplastic anemia in 1 case of all cases. For all cases, vaginal delivery and cesarean section were 23 and 19 cases, respectively. Postpartum hemorrhage happened in 3 cases, and eonatal thrombocytopenia happened in 1 case. Conclusions ： Many reasons may cause thrombocytopenia during pregnancy. Based on treatments for the cause, Application of platelet agent, corticosteroid and immune globulin is effective treatment for severe thrombocytopenia during pregnancy.