妊娠合并血小板减少的临床分析

目的:探讨妊娠期血小板减少的病因及处理方法。方法:回顾性分析我院36例妊娠合并血小板减少患者临床资料。结果:妊娠期血小板减少症(PAT)17例占47.2%,特发性血小板减少性紫癜(ITP)12例占33.3%,妊娠高血压综合征(PIH)2例占5.5%,其他病因包括血栓性血小板减少性紫癜2例,上呼吸道病毒感染者2例,Evans综合征1例。血小板减少出现最早孕周为3周,<12周出现5例(13.9%),12～28周出现6例(16.7%),>28周出现25例(69.4%);对血小板减少严重的病例可以应用糖皮质激素、输注浓缩血小板或IVIgG治疗。全部病例无孕产妇死亡。结论:妊娠血小板减少原因较多,应依据不同病情进行处理。对血小板减少严重的病例,根据不同病因,应用糖皮质激素、输注浓缩血小板或IVIgG治疗效果较好。

Clinic Analysis of Thrombocytopenia in Pregnancy

Objective: To study the causes and management of thrombocytopenia during pregnancy. Methods: The data of 36 cases with thrombocytopenia during pregnancy were analyzed retrospectively. Results: Thrombocytopenia was mainly caused by pregnancy-associated thrombocytopenia(PAT) in 17 cases, idiopathic thrombocytopenia purpura (ITP) in 12 cases, pregnancy induced hypertension(PIH) 2 cases; other causes included thrombia thrombocytopenia, viral infection, Evans Syndrome. Thrombocytopenia was identified as early as 3rd weeks of pregnancy, 5 cases were found before 12th weeks; 6 cases were found between 12th and 28th weeks, 25 cases were found after 28th weeks. Corticosteroid, platelet transfusion or intravenous immunoglobulin(IVIG) were the choice for severe cases. No maternal death were found. Conclusion: Pregnancy thrombocytopenia usually becomes evident in the third trimester. PAT is the most common type of thrombocytopenia during pregnancy. Glucocorticoid and platelet transfusion is effective for severe thrombocytopenia during pregnancy.