妊娠合并血小板减少病因及治疗的回顾性调查

Retrospective Study on Etiology and Treatment of Thrombocytopenia in Pregnancy Combined with Thrombocytopenia

目的探讨妊娠合并血小板减少的病因及治疗方法。方法回顾性调查2010—2015年甘肃省武威市妇幼保健计划生育服务中心产科收治的349例妊娠合并血小板减少患者的临床资料,分析病因、不同治疗方法的效果、血小板减少对新生儿和母体的影响及相互关系。结果妊娠合并血小板减少以妊娠期血小板减少(gestational thrombocytopenia,GT)最为常见,占52.72%。57例重度血小板减少患者分别接受肾上腺皮质激素、丙种球蛋白(IVIG)和激素+丙种球蛋白3种药物治疗,接受3种治疗方法患者的血小板均显著升高(P<0.05)。结论妊娠合并血小板减少以GT最常见。治疗方式取决于血小板水平,肾上腺皮质激素、IVIG及二者联合治疗均有效,且以二者联合用药效果最佳。新生儿血小板减少与母体孕期血小板减少呈正相关。

OBJECTIVE To disscuss the etidogy and treatment of thrombocytopenia in pregnancy. METHODS The retrospective investigation from 2010 to 2015 was conducted in Department of Obstetrics Gynecology of Wuwei Marternal and Child Healthcare Center in Gansu, 349 women presenting with thrombocytopenia were recorded to analyze the etiology, different treatment method effects,the influences and interrelations of thrombocytopenia on the newborn and maternal. RESULTS The most common causes of thrombocytopenia during pregnancy was gestational thrombocytopenia（GT）,which accounted 52.72%. 57 patients accepted including cortin,intravenous immunoglobulin（VIG） and the combination, whose blood platelet all significantly increased（P〈0.05）. CONCLUSIONS The commonest cause of thrombocytopenia during pregnancy was GT. The management mode was affected by blood platelet. Cortin,IVIG and the combined treatment were all effective, while the combination had better effect. The thrombocytopenia among the newborn was positively associated with GT.