妊娠相关性血小板减少症临床特点分析

目的探讨妊娠相关性血小板减少症（PAT）患者的临床特点。方法选择2012年1月至2013年12月在自贡市第一人民医院产科分娩的60例PAT患者为研究对象，纳入血小板减少组（妊娠期检查发现2次以上血小板计数〈100×10^9／L）。选择同期在同一家医院分娩的60例正常孕妇纳入血小板正常组（血小板计数≥100×10^9／L）。采用回顾性分析方法，比较两组孕妇的分娩方式、麻醉方式、产前凝血功能、产时出血量及所产新生儿出生时情况，并观察血小板减少组患者治疗情况、产后血小板恢复情况等。本研究遵循的程序符合自贡市第一人民医院人体试验委员会制定的伦理学标准，得到该委员会批准，分组征得受试对象知情同意，并与之签署临床研究知情同意书。两组孕妇年龄、分娩孕龄及初产妇与经产妇所占比例等比较，差异均无统计学意义（P〉0．05）。结果①两组孕妇分娩方式及剖宫产时麻醉方式构成比比较，差异均有统计学意义（x2=29．40，42．57；P〈0．05）。血小板减少组分娩方式以剖宫产为主，并且其中剖宫产分娩者的麻醉方式以全身麻醉为主。血小板正常组分娩方式以阴道分娩为主，其中剖宫产分娩者的麻醉方式全部采用持续硬膜外麻醉或蛛网膜下腔麻醉。②血小板减少组孕妇剖宫产率及剖宫产时全身麻醉率均有随血小板减少程度增加而增加的趋势（x2=3．11，P=0．04；x2=17．51，P=0．00）。③两组孕妇产前凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FG）和阴道分娩及剖宫产产时出血量比较，差异均无统计学意义（t=1．24，1．61，0．42，0．93，1．58；P〉0．05）。④两组孕妇所产新生儿出生体质量及血小板计数比较，差异均无统计学意义（t=0．860，1．206；P〉0．05）。⑤本组血小板减少组孕妇产前及产后未做特殊治疗?

Clinical Feature Analysis of Pregnancy Associated Thrombocytopenia

Objective To investigate clinical features of pregnancy associated thrombocytopenia （PAT）. Methods A total of 60 PAT pregnant women who delivered in Zigong First Hospital from January 2012 to December 2013 were bringing into thrombocytopenia group （more than twice detection results showed platelet count〈 100 × 10^9/L during pregnancy）. Meanwhile,other 60 normal pregnant women who delivered at same hospital were bringing into platelet count normal group（platelet count≥100 × 10^9/L during pregnancy）. All clinical data were analyzed by retrospective method, including delivery way, anaesthesia, prenatal eoagulative function, amount of intrapartum hemorrhage, and neonatal birth conditions were compared between two groups. The treatments and recover conditions of platelet after delivery were also observed in thromboeytopenia group. The study protocol was approved by the Ethical Review Board of Investigation of Zigong First Hospital. Informed consent was obtained from each participant. There were no significant differences between two group5 in age , delivery gestational age of pregnant woman and percentage of primiparous and multiparous（P〉0. 05）. Results （1）The constituent ratio of delivery ways and anaesthesia modes between two groups had statistically differences （ X2 = 29. 40,42. 57 ; P 〈 0. 05 ）. Caesarean section was the main delivery way in thrombocytopenia group and general anaesthesia was used in the most cases during caesarean section. Vaginal delivery was reliable in the most cases in platelet count normal group and epidural or subarachnoid anaesthesia were used in whom chosed caesarean section. （2）Caesarean section rate and general anaesthesia rate were increased following by decreasing degree of platelet count in thrombocytopenia group （ X2 = 3. 11, P = 0.04 ; X2 = 17. 51, P = 0.00）. （3） There were no statistically differences between two groups in prothrombin time（PT）, activated partial thromboplastin time （APTT） and fibrinogen（FG） before delivery