妊娠合并血小板减96例临床分析(1)
 |
| 第1页 |
参见附件(3830KB，3页)。
[摘要] 目的 探讨妊娠合并血小板减少症的临床特点及围生期处理方法。方法 对96例妊娠合并血小板减少患者的临床资料进行回顾性分析结果。结果 单纯由妊娠引起的血小板减少占31.23%，特发性血小板减少性紫癜占22.92%，合并妊娠高血压疾病占10.42%，巨幼红细胞贫乏占5.21%，脾功能亢进和抗磷脂综合症各为2.08%，再生障碍性贫血为3.13%， 系统性红斑狼疮和白血病各1.04，骨髓增生异常综合症1.04%，妊娠肝内胆汁淤积综合症4.17%，原因不明15.63%。血小板减少出现最早孕周为20+4w，<28周出现的占20.96%，>28周占79.04%，大部分孕妇血小板减少出现在妊娠晚期。对血小板<50×109/L有出血倾向及血小板<20×109/L者用强的松治疗，分娩前后使用血小板制剂，同时考虑剖宫产。医院同期产后出血率为1.14%，96例血小板减少患者产后出血12例，产后出血率为12.5%，与同期正常产妇相比，差异有统计学差异(P<0.05)。妊娠合并血小板减少组新生儿无1例发生颅内出血，与同期正常新生儿组颅内出血数相比，经统计学处理，P>0.05，两者之间差异无统计学意义。未输注血小板患者在产后5d内均恢复正常。结论 妊娠期血小板严重减少(血小板<50×109/L)可能增加产后出血机率，但阴道分娩未增加新生儿颅内出血的危险。
[关键词]妊娠； 血小板减少； 产后出血
[中图分类号] R714.1[文献标识码] B[文章编号] 1005-0515(2011)-02-011-02
Clinical analysis of 96 thrombocytopenia in pregnancy
CHEN_qun
(Pan Lei.Medical Department of Hematology, Wuhan No.1 Hospital, Wuhan 430022,Hubei, China)
[Abstract] Objective To explore the causes, management and outcome of pregnant women with thrombocytopenia. Methods 96 cases with thrombocytopenia were reviewed. Results Thrombocytopenia was mainly caused by prelacy-associated thrombocytopenia in 31.23%, idiopathic thrombocytopenia in 22.92%, pregnancy induced Hypertension 10.42%, megaloblastic anemia in 5.21%, hypersplenism and anti-phospholipid syndrome each 2.08%, systemic lupus erythematosus and leukemia each 1.04%, bone narrow hyperplasia abnormality in 1.04%, aplastic anemia in 3.13%, hemolysis eleavated liverenzymes and low platelets in 4.17% cases, the reason unknown in 15.63%. Thrombocytopenia was identified initially at 20+4 weeks of gestation, 20.96% cases were found before 28weeks, 79.04% cases were found after 28 weeks. Prednisone was considered if the platelet count was less than 50×109PL. Platelet transfusion was given to those with platelet count less than 50×109PL before and after delivery. If the platelet count was less than 50×109PL cesarean delivery might be performed. Pregnancy accompanied with idiopathic thrombocytopenic purpuramay delivery from vagina. The occurrence of postpartum hemorrhage was 4 cases ......
您现在查看是摘要介绍页，详见PDF附件(3830KB，3页)。