218例妊娠合并血小板减少临床分析

目的探讨妊娠合并血小板减少的围产期处理及产后出血情况。方法收集2006年1月至2011年8月茂名市人民医院及广州医学院第三附属医院收治的218例妊娠合并血小板减少患者，根据分娩前血小板计数51×109-99×109／L、21×109-50×109／L、≤20×109／L分为A、B、C三组，每例患者针对原发病治疗，产前根据病情适当给予糖皮质激素，静脉注射丙种球蛋白，输入血小板治疗，分析各组的产后出血情况。结果A、B、C三组的产后出血发生率分别为2．67％、7．46％、28．20％；平均出血量分别为（600±80）、（600±120）、（900±200）ml，产后24h平均阴道流血量分别为（250±30）、（250±80）、（500±100）ml，C组平均出血量及24h平均阴道流血量与A、B组比较，差异均有统计学意义（P〈0．05）。结论妊娠合并血小板减少，在治疗原发病的基础上，给予对应治疗，适时终止妊娠可有效改善不良妊娠结局。

Clinical analysis of 218 pregnant women complicated with thrombocytopenia

Objective To investigate perinatal treatment of pregnancy with thrombocytopenia and the case of postpartum hemorrhage. Methods The clinical data of 218 pregnant women complicated with thrombocytopenia were taken from January 2006 to August 2011 in Maoming People＇s Hospital, the Third Affiliated Hospital of Guangzhou Medical College. According to the platelet count before delivery of 51×109-99×109/L、21×109-50×109/L,and ≤20×109/L,the patients were divided into A, B, C group. Each patient was treated for the primary disease. According to the condition, appropriate prenatal corticosteroids, intravenous immunoglobulin, and platelet transfusion therapy were applied.Postpartum hemorrhage was analyzed. Results A, B, C groups of postpartum hemorrhage rates were 2.67%, 7.46%,and 28.20%, respectively. 24 h average postpartum vaginal bleeding volume of group A, B and C were （250±30）, （250±80）, and （500±100） ml, respectively, showing significant difference （P〈0.05）. Conclusions Pregnant women complicated with thrombocytopenia, on the basis of the treatment of the primary diseases, glucocorticoid, immunoglobulin and platelet transfusion therapy are effective to treat the disease. Timely choose the appropriate mode of delivery for termination of pregnancy can effectively improve the adverse pregnancy outcome.