妊娠合并血小板减少症135例临床分析

Clinical analysis of 135 cases of pregnancy complicated with thrombocytopenia

目的探讨妊娠合并血小板减少症(PT)患者对妊娠结局的影响。方法回顾性分析2016年1月至2019年10月期间阳江市人民医院妇产科收治的135例PT患者的临床资料,按病情的严重程度分为轻度PT患者55例(观察A组)、中度PT患者45例(观察B组)、重度PT患者35例(观察C组),选择同期我院接诊的75例正常妊娠孕妇作为对照组。比较各组孕妇的血小板计数(PLT)、血小板平均体积(MPV)、血小板分布宽度(PDW)、妊娠结局和新生儿情况。结果随着病情的加重,四组孕妇的PLT水平逐渐降低,MPV、PDW逐渐升高,组间比较差异均有统计学意义(P<0.05);四组孕妇的剖腹产率和贫血率比较差异无统计学意义(P<0.05);随着病情的加重,早产率、产后出血率逐渐升高,组间比较差异均有统计学意义(P<0.05);三组PT孕妇的新生儿均存活,新生儿平均体质量比较,差异无统计学意义(P>0.05);随着病情的加重,新生儿血小板减少率逐渐升高,观察C组孕妇的新生儿血小板减少率明显高于观察A组和观察B组,观察B组又高于观察A组,差异均有统计学意义(P<0.05)。结论PT患者血小板数量的减少会导致早产和产后出血的概率增加,容易增加新生儿血小板减少的发生率,不利于PT患者的妊娠结局。

Objective To explore the influence of pregnancy with thrombocytopenia(PT)on pregnancy outcome.Methods A retrospective analysis was conducted on the clinical data of 135 patients with PT admitted to the Department of Obstetrics and Gynecology at People’s Hospital of Yangjiang from January 2016 to October 2019.According to the severity of the disease,they were divided into 55 patients with mild PT(observation group A),45 patients with moderate PT(observation group B),and 35 patients with severe PT(observation group C).Seventy-five normal pregnant women admitted to our hospital during the same period were selected as the control group.The platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW),pregnancy outcome and neonatal condition were compared between the pregnant women in each group.Results With the aggravation of the disease,the PLT levels of the four groups gradually decreased,and the MPV and PDW gradually increased;all differences between the groups were statistically significant(P<0.05).There was no significant difference in the rate of caesarean section and anemia among the four groups of pregnant women(P>0.05).As the illness aggravating,premature birth rate and postpartum hemorrhage rate gradually increased,and the differences between the groups were statistically significant(P<0.05).The newborns of the three groups of PT pregnant women all survived,but there was no statistically significant difference in the average weight of the newborns(P>0.05).With the worsening of the disease,the rate of neonatal thrombocytopenia gradually increased.The rate of neonatal thrombocytopenia of pregnant women in observation group C was significantly higher than that in observation group A and observation group B,and the rate in observation group B was higher than that in observation group A;all differences between the groups were statistically significant(P<0.05).Conclusion The decrease in the platelet number will increase the probability of premature delivery and postpartum hemorrhage in PT patients,which is likely to increase the incidence of thrombocytopenia in newborn.These are not conducive to the pregnancy outcome of PT patients.