妊娠合并血小板减少疾病103例临床分析

Clinical analysis of 103 cases of thrombocytopenia in pregnancy

目的 对妊娠合并血小板减少疾病与产科高危因素,以及产科并发症相关关系进行的研究.方法 对2006～2010年西安交通大学医学院第二附属医院收治的103例妊娠合并血小板减少孕妇与105例正常孕妇进行回顾性病例对照研究.结果 孕妇血小板减少的主要原因为妊娠相关性血小板减少（68.9%）、妊娠高血压疾病（9.7%）和特发性血小板减少性紫癜（5.8%）.血小板减少孕妇的胎盘早剥、引产、剖宫产、产钳、产后出血和输血发生率明显高于正常孕妇（χ2值分别为3.748、12.491、18.289、6.886、4.801、20.468,均P〈0.05）.结论 大多数轻度血小板减少孕妇预后良好,无需特殊处理.中重度血小板减少孕妇多与严重的原发病有关,如妊娠期高血压疾病和特发性血小板减少性紫癜等.这些原发病应是关注和治疗的重点.

Objective To investigate the relationship between thrombocytopenia in pregnancy and obstetric high risk factors and complications. Methods A retrospective case-control study was conducted to compare 103 pregnant women complicated with thrombocytopenia and 105 pregnant women without thrombocytopenia who delivered between January 2006 to April 2010. Results The main causes of thrombocytopenia were pregnancy-associated thrombocytopenia （PAT） （ 68.9% ）, pregnancy hypertension disease （ PHD ） （9.7%）, and idiopathic thrombocytopenic purpura （ITP） （5.8%）. The incidence rates of placental abruption, induced abortion, cesarean section, obstetrical forceps, postpartum hemorrhage and blood transfusion in cases of thrombocytopenia were significantly higher than those in pregnant women without thrombocytopenia （χ2 was 3. 748, 12. 491, 18. 289, 6. 886, 4. 801 and 20.468 respectively, P 〈 0.05）. Conclusion Most pregnant women with mild thrombocytopenia have good prognosis and don＇ t need special treatment. Moderate to severe thrombocytopenia is related with severe primary disease in most cases, such as PHD and ITP. Special attention should be given to patients with primary diseases.