新生儿血小板减少症48例临床分析

NEONATAL THROMBOCYTOPENIA:A CLINICAL ANALYSIS OF 48 CASES

目的总结分析新生儿血小板减少症(NTP)的病因及临床特点。方法收集2009年6月—2013年10月我院新生儿科收治的NTP病儿48例,分析其病因、临床表现、治疗措施及预后。结果感染性疾病导致NTP占52.1%,生后细菌感染占41.7%,TORCH感染占10.4%;窒息低氧导致NTP占29.2%。重症血小板减少症(<50×109/L)21例(43.8%),早期血小板减少症(生后≤72h)26例(54.2%)。45例(93.8%)病儿经治疗好转或治愈,3例(6.3%)宫内TORCH感染及存在严重窒息的早期重症NTP病儿死亡。结论临床上引起NTP的病因复杂多样,积极治疗原发病极其关键,绝大多数预后良好。宫内TORCH感染、严重窒息、早期重症血小板减少症病儿预后不良。

Objective To summarize the causes and clinical features of neonatal thrombocytopenia （NTC）. Methods Clinical data of 48 cases of NTC who were treated in our department, during June 2009--October 2013, were collected. The cau- ses, clinical manifestations, treatment and prognosis were analyzed. Results The causes of NTC were： infectious diseases ac- counted for 52.1%, in which,41.7% were postnatal bacterial infections, and 10.4% were TORCH infeetion; 29.2% were due to asphyxia and hypoxia. Severe thrombocytopenia （〈50 × 109/L） was recorded in 21 （43.8%） cases, and early thrombocytopenia （472 h after birth） 26 （54.2%） cases. Forty-five were cured or improved, three （6.3%） sick kids died of intrauterine TORCH in- fection and severe asphyxia. Conclusion The causes of NTC are complicated and diversified, an active treatment of its primary diaseases is extremely important, most of the patients will get favourable prognosis. A poor prognosis is predicted in children with early severe NTC who had intraurine TORCH infection and severe asphyxia.