妊娠期血小板减少76例临床分析

Clinical analysis of 76 cases with gestational thrombocytopenia

目的 探讨妊娠期血小板减少的原因及临床处理对策。方法 回顾性分析汕头大学医学院第一附属医院 1 993～ 2 0 0 3年间 76例妊娠合并血小板减少患者临床资料。结果 妊娠期血小板减少的患者中 ,72 3%为妊娠期血小板减少症 (gestationalthrombocytopenia ,GT) ,1 4 5 %为妊娠高血压综合征 (PIH) ,特发性血小板减少性紫癜 (ITP)占 9 2 %。其中GT组不需要特别处理 ,PIH组以皮质激素及输血小板为主 ,ITP组以皮质激素或免疫球蛋白 (IVIG)为主。血小板低于 2 0× 1 0 9/L时输注血小板。全部病例无孕产妇死亡及新生儿血小板减少。结论 妊娠期血小板减少原因较多 。

Objective To study the causes and management of thrombocytopenia during pregnancy.Methods The data of 76 cases with thrombocytopenia during pregnancy in the First Affiliated Hospital of Shantou University Medical College from 1993 to 2003 were analyzed retrospectively.Results Of them,72 3% were gestational thrombocytopenia (GT),14\^5% were hypertensive disorders during pregnancy,and 9\^2% were idiopathic thrombocytopenia purpura (ITP).No special treatment was necessary for the patients with GT;prednisone and platelet transfusion were primary treatment for those with hypertensive disorders,and for ITP,prednisone or intravenous immunoglobulin (IVIG) was the first choice.The transfusion of platelet was necessary for patients with platelet less than 20×10 9/L.In all cases,no maternal death occurred,and no neonatal thrombocytopenia was observed.Conclusion Several kinds of disorders during pregnancy can lead to gestational thrombocytopenia.The treatment should be different according to different causes.