摘要
目的:分析不同病因妊娠合并血小板减少患者临床特点及治疗后分娩结局。方法:选取2018年5月2020年12月本院收治的妊娠合并血小板减少患者118例临床资料,根据病因分为妊娠期血小板减少症(GT)、特发性血小板减少性紫癜(ITP)、妊娠期高血压疾病(HDCP)及其他;并根据血小板计数(PLT)检查结果评估血小板减少严重程度,<100×10^(9)/L为轻度,20~50×10^(9)/L为中度,<20×10^(9)/L为重度。观察患者不同病因分布及其血小板减少严重程度,比较经治疗后不同病因、血小板减少程度患者的妊娠分娩结局。结果:GT6例(55.9%)、ITP 26例(22.0%)、HDCP 17例(14.4%)、其他病因9例(7.6%)。妊娠合并血小板减少不同病因患者血小板减少严重程度有差异(P<0.05)。GT组主要为轻度,其占比高于中重度,ITP组中重度占比高于轻度(均P<0.05);HDCP组血小板减少严重程度占比未见差异(P>0.05),其他病因的重度占比高于轻度(P<0.05)。GT组剖宫产率、输血率低于ITP组、HDCP组及其他组(P<0.05);GT组与ITP组新生儿早产率与窒息率无差异,两组早产与窒息率均低于HDCP组及其他组(均P<0.05)。血小板减少中度的产妇产后出血率(12.1%)高于重度(0),血小板减少重度的产妇新生儿早产率(46.4%)、窒息率(17.9%)高于轻度(10.5%、1.8%)(均P<0.05)。结论:妊娠合并血小板减少的病因不同,其血小板减少程度、治疗与预后各有差异;该病以GT为常见原因,妊娠分娩结局良好,其他病因的血小板减少程度更严重,妊娠分娩结局较差,需及时诊断、合理规范治疗以改善预后。
Objective:To analyze the clinical characteristics and pregnancy outcomes of pregnant women with thrombocytopenia because of different aetiologies.Methods:The clinical data of 118 pregnant women with thrombocytopenia from May 2018 to December 2020 were selected,and these women were divided in group A(women with gestational thrombocytopenia(GT)),group B(women with idiopathic thrombocytopenic purpura(ITP)),group C(women with hypertensive disorder complicating pregnancy(HDCP)),and group D(women with others aetiologies)according to the different aetiologies.And according to the severity of thrombocytopenia of the women based on the results of the platelet count(PLT)test,these women were also divided into group E(women with PLT<100×10^(9)/L),group F(women with PLT 20-50×10^(9)/L),and group G(women with PLT<20×10^(9)/L).The distribution of the women with thrombocytopenia because of different etiologies,and the severity of thrombocytopenia of the women were observed.The pregnancy outcomes after treatment were compared among the women with thrombocytopenia because of different etiologies,and among the women with different severity of thrombocytopenia.Results:There were 66(55.9%)women in group A,26(22.0%)women in group B,17(14.4%)women in group C,and 9(7.6%)women in group D.There were significant differences in the proportions of different severity of thrombocytopenia of the women among group A,group B,group C,and group D(P<0.05).In group A,the proportion of mild thrombocytopenia of the women was significantly higher than that of moderate to severe thrombocytopenia of the women.In group B,the proportion of moderate to severe thrombocytopenia of the women was significantly higher than that of mild thrombocytopenia of the women(all P<0.05).There were no significant differences in the proportions of the different severity of thrombocytopenia of the women in group C(P>0.05),and the proportion of severe thrombocytopenia of the women in group D was significantly higher than that of mild thrombocytopenia of the women(P<0.05).The rates of cesarean section and blood transfusion of the women in group A were significantly lower than those of the women in group B,group C,or group D(P<0.05).The rates of preterm birth and asphyxia of newborns had no significant differences between group A and group B,and which in group A and group B were significantly lower than those in group C and group D(all P<0.05).The postpartum hemorrhage rate(12.1%)of the women in group E was significantly higher than that(0)of the women in group G.The preterm birth rate(46.4%)and asphyxia rate(17.9%)of the women in group G were significantly higher than those(10.5%and 1.8%)of the women in group E(all P<0.05).Conclusion:The causes of thrombocytopenia of the pregnant women are various,and the severity,the treatment,and the prognosis also vary among the women with different causes of thrombocytopenia.GT is the common cause of thrombocytopenia,and the pregnancy outcomes of the women with thrombocytopenia by GT are good.The severity of thrombocytopenia of the women by other causes is quite serious,and the pregnancy outcomes are relatively poor.So,the timely diagnosis,and reasonable and standardized treatment of thrombocytopenia of the pregnant women can improve their prognosis.
作者
李清娟
张全华
张玲
LI Qingjuan;ZHANG Quanhua;ZHANG Ling(The First Affiliated Hospital of Xinxiang Medical College,Henan Province,453100)
出处
《中国计划生育学杂志》
2022年第9期2081-2085,共5页
Chinese Journal of Family Planning
关键词
妊娠合并血小板减少
病因
临床特点
治疗
妊娠结局
Thrombocytopenia during pregnancy
Aetiology
Clinical characteristics
Treatment
Pregnancy outcomes
