新生儿血小板减少症102例临床分析

Clinical analysis of 102 cases of neonatal thrombocytopenia

目的探讨新生儿血小板减少症(NTP)的病因、临床特点及治疗。方法回顾性分析102例NTP患儿的临床资料,包括病因、临床表现及治疗方法。结果 102例NTP患儿中,60例(58.8%)为感染导致的血小板减少,10例(9.8%)围生期窒息缺氧,8例(7.8%)坏死性小肠结肠炎(NEC),9例(8.8%)同族免疫性血小板减少,11例(10.8%)被动免疫性血小板减少,其他4例(3.9%)。61.8%的患儿无出血表现,多见皮肤出血点或紫癜、瘀斑、消化道出血、颅内出血及弥散性血管内凝血(DIC)。经病因及对症治疗后患儿血小板计数很快恢复正常,大部分预后良好。结论 NTP的临床表现不典型,病因复杂多样,早期针对病因进行治疗及对症治疗,可提高治疗效果,改善预后。

Objective To explore the etiology, clinical manifestations and treatment of neonatal thrombocytopenia(NTP). Methods The clinical data of 102 NTP children were retrospectively analyzed, which including etiology, clinical manifestations and treatment methods. Results Of 102 children with NTP, 60 cases(58.8%) with thrombocytopenia caused by infection, 10 cases(9.8%) caused by perinatal asphyxia, 8 cases(7.8%) caused by necrotizing enterocolitis(NEC), 9 cases(8.9%) were homologous immune thrombocytopenia, 11 cases(10.8%) were passive immune thrombocytopenia, 4 cases(3.9%) caused by other reasons. There were 61.8% of children had no hemorrhage manifestations, and the skin bleeding spots or purpura, ecchymosis, gastrointestinal bleeding, intracranial hemorrhage and disseminated intravascular coagulation(DIC) were common. After etiological treatment and symptomatic treatment, platelet count of children recovered quickly, and most of them had good prognosis. Conclusion The clinical manifestations of NTP are not typical and the etiology is complex and diverse. Early etiological treatment and symptomatic treatment can improve the treatment effect and prognosis.