妊娠合并血小板减少136例临床研究

目的：探讨妊娠合并血小板减少的原因及围生期处理方法。方法：回顾性分析2005年10月-2011年4月产科分娩的136例妊娠合并血小板减少患者临床资料。结果：妊娠合并血小板减少的主要原因有妊娠相关性血小板减少症（PAT）79例（58．09％）、妊娠期高血压疾病（PIH）21例（15．44％）、特发性血小板减少性紫癜（ITP）18例（13．24％）、妊娠期肝内胆汁瘀积症（ICP）16例（11．76％）；阴道分娩52例，剖宫产84例；产后出血16例，产褥感染1例。结论：多种原因可以导致妊娠妇女血小板减少。PAT是最常见类型。治疗采用针对病因治疗的基础上给予糖皮质激素、丙种球蛋白、输血小板等综合治疗。分娩方式视血小板多少及有无产科指征而定。

Clinical Analysis of 136 Pregnant Women Complicated with Thrombocytopenia

Objective： To explore the etiopathogenesis and perinatal management in pregnant women complicated with thrombocytopenia. Mothods： The clinical data of 136 pregnant women complicated with thrombocytopenia in our hospital from October 2005 to April 2011 were reviewed. Results： Thrombocytopenia was mainly caused by pregnancy-associated with thrombocytopenia （PAT） in 79 cases （58.09%）, pregnancy induced hypertension（PIH） in 21 cases （15.44%）, idiopathic thrombocytopenia（ITP） in 18 cases（13.24%）, intrahepafic cholestasis of pregnancy（ICP） in 16 cases（11.76%）. Among the 136 pregnant women , 52 cases chose vaginal delivery and 84 cases chose cesarean section. There were 16 cases with postpartum hemorrhage and I case with puerperal infection. Conclusion： The reasons caused thrombocytopenia during pregnancy are diverse. Pregnancy-associated with thrombocytopenia is the most prevalent cause in pregnant women complicated with thrombocytopenia. On the basis of the treatment of the primary diseases, glucocorticoid, immunoglobulin and platele transfusion are effective to treat the disease. The mode of delivery is decided by the platelet count and obstetrical indication.