术前轻度血小板减少症对剖宫产术后产后出血的影响

  目的  分析轻度血小板减少症是否与剖宫产妇女产后出血风险相关。  方法  将2018年9月至2021年6月在云南省昆明市妇幼保健院产科接受剖宫产的所有妇女纳入研究进行回顾性分析，根据血小板浓度将研究对象分为血小板计数正常（≥150000/μL）组与轻度血小板减少症（100000～149000/μL）组，观察产妇产后出血、输血、伤口并发症（手术部位感染、裂开或血肿）和产后急诊就诊情况。  结果  在918名女性中，832名（90.6%）的血小板计数正常，86例（9.4%）有轻度血小板减少症，血小板计数正常的女性与轻度血小板减少症的女性相比，产后出血（13.5% vs 14.0%，OR = 1.16，95%CI 0.88～1.54，P = 0.801）、需要输血（6.5% vs 6.7%，OR = 1.34，95%CI0.80～2.24，P = 0.622）、伤口并发症（4.5% vs 5.4%，OR = 1.53，95%CI 0.88～2.64，P = 0.494）或产后急诊就诊（9.0% vs 10.7%，OR = 1.37；95%CI0.92～2.03，P = 0.346）的风险没有差异。  结论  剖宫产妇女的术前轻度血小板减少症与产后出血、输血、伤口并发症或产后急诊就诊等无关。

The Influence of Preoperative Mild Thrombocytopenia on Postpartum Hemorrhage after Cesarean Section

  Objective   The purpose of this study is to analyze whether mild thrombocytopenia is associated with an increased risk of postpartum hemorrhage in women undergoing cesarean section.   Methods   All women who underwent cesarean section in the department of gynecology in our hospital from September 2018 to June 2021 were included in the study for retrospective analysis. The study subjects were divided into normal platelet count group （≥150000/μL） and mild thrombocytopenia group （100000～149000/μL） according to the platelet concentration. The maternal postpartum hemorrhage, blood transfusion, wound complications （infection, dehiscence or hematoma at the operation site） and postpartum emergency visits were observed.   Results   Among 918 women, 832 （90.6%） had the normal platelet counts, and 86 （9.4%） had mild thrombocytopenia. Compared with the women with mild thrombocytopenia, there was no difference in risks of postpartum hemorrhage （13.5% vs 14.0%, OR = 1.16, 95% CI 0.88-1.54, P = 0.801） , need for blood transfusions （6.5% vs 6.7%, OR = 1.34, 95%CI 0.80-2.24, P = 0.622）, wound complications （4.5% vs 5.4%, OR = 1.53, 95%CI 0.88-2.64, P = 0.494） or emergency postpartum visits （9.0% vs 10.7%, OR = 1.37; 95%CI 0.92–2.03, P = 0.346） for the women with the normal platelet counts.   Conclusion  The preoperative mild thrombocytopenia of cesarean section women has nothing to do with the postpartum hemorrhage, blood transfusion, wound complications or postpartum emergency visits.