目的 探讨妊娠合并血小板减少的病因、规范化治疗方案及分娩方式的选择。方法 回顾性分析2009-01至2018-12解放军总医院第七医学中心产科127例妊娠合并血小板减少患者资料,对其病因、规范化治疗方案、分娩方式及妊娠结局等进行临床分析。结果 妊娠合并血小板减少的病因以妊娠相关性血小板减少症(pregnancy-related thrombocytopenia,PAT)和特发性血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)居多,构成比分别为62.20%和19.69%,显著高于妊娠期高血压疾病(pregnancy hypertensive disorders,PHD)、妊娠期胆汁淤积综合征(intrahepatic cholestasis of pregnancy,ICP)及系统性红斑狼疮(systemic lupus erythematosus,SLE)。根据具体病情及病因选择监测观察、治疗原发疾病、糖皮质激素及免疫球蛋白输注、血小板输注等治疗。分娩方式主要由产科指征决定。结论 正确诊断并规范化、个体化治疗妊娠合并血小板减少,是降低妊娠并发症发生率、改善妊娠结局的关键。
Abstract
Objective To investigate the etiology,standard therapy and delivery mode of pregnancy complicated with thrombocytopenia.Methods The clinical data about 127 cases of pregnancy complicated with thrombocytopenia treated between 2009 and 2018 was studied retrospectively. Clinical analysis was made of the etiology,therapeutic effects of different treatments,delivery modes and outcomes of pregnancy.Results Pregnancy-associated thrombocytopenia and idiopathic thrombocytopenic purpura were the main causes of pregnancy complicated with thrombocytopenia,accounting for 62.20% and 19.69% respectively.There was statistically significant difference compared with the incidences of other etiologies(P＜0.05).All the patients underwent different treatments including glucocorticoid,intravenous immunoglobulin and platelet transfusions according to their symptoms.And the mode of delivery was mainly determined by obstetric factors.Conclusions Accurate diagnosis,standard and individualized treatment of pregnancy complicated with thrombocytopenia can reduce pregnancy complications and improve outcomes of pregnancy.
关键词
妊娠 /
血小板减少 /
病因 /
临床分析
Key words
pregnancy /
thrombocytopenia /
etiology /
clinical analysis
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