晚期妊娠合并ITP的治疗及妊娠结局分析

目的探讨晚期妊娠合并特发性血小板减少性紫癜（ITP）的治疗及妊娠结局，以为临床提供参考。方法对本院收治的54例晚期妊娠合并特发性血小板减少性紫癜的患者给予泼尼松、丙种球蛋白治疗，观察其疗效，并与正常对照组54例产妇的妊娠结局进行比较。结果观察组患者治疗后，20例有出血倾向的患者均得到有效控制，所有患者分娩前2周，血小板计数（PLT）均〉30×10^9／L。观察组患者的町、APTI、PLT用与对照组比较，差异有统计学意义（P〈0．05）；观察组的胎儿PLT与对照组比较，差异无统计学意义（P〉0．05）。两组刮宫产情况，差异有统计学意义（P〈0．05）。观察组产妇有9例产后出血、7例阴道壁血肿，对照组产后有2例产后出血、1例阴道壁血肿，两组间比较，差异有统计学意义（P〈0．05）；观察组新生儿PLT〈100×10^9／L7例，对照组0例。两组均无新生儿颅内出血、窒息及死亡出现。结论晚期妊娠合并特发性血小板减少性紫癜对母儿的妊娠结局有影响，一旦发现应积极治疗，根据产前血小板的计数情况及有无出血选择合适的分娩方式．以减少并发症．提高母儿的预后。

The treatment and the pregnancy outcome analysis of late pregnancy with ITP

Objective To study the treatment and the pregnancy outcome analysis of late pregnancy with ITP,in order to provide reference for clinical.Methods Retrospectively 54 cases of pregnancy with idiopathic thrombocytopenic purpura patients were given prednisone,C-type globulin treatment.The curative effect was observed,and compared with normal control group of 54 mothers pregnancy outcomes.Results The observation group patients after treatment,20 cases had haemorrhage tendency of patients were effectively controlled,all patients with 2 weeks before delivery,platelet count all>30×109/L.The PT,APTT,PLT in the observation group compared with the control group,the difference was statistically significant(P < 0.05);the fetus PLT in the observation group compared with the control group,the difference was not statistically significant(P > 0.05).The cesarean section of the two groups,the difference was statistically significant(P < 0.05).The observation group puerpera had 9 cases of postpartum hemorrhage,7 cases of vaginal wall hematoma,and the control group had 2 cases of postpartum hemorrhage,1 case after vaginal wall hematoma,and comparison between the two groups,the difference was statistically significant(P < 0.05);the observation group had 7 cases neonatal PLT<100×109/L and in the control group was 0.Both groups without neonatal intracranial bleeding,choking and deaths occur.Conclusion Pregnancy with idiopathic thrombocytopenic purpura mother and son of pregnancy outcomes have influence,once discovery should be actively treatment,according to platelet count and prenatal or bleeding learning is the right delivery methods,in order to reduce the complications,improve the prognosis of female son.