妊娠合并血小板减少79例临床探究

摘要

目的：探讨妊娠合并血小板减少的临床表现、致病因素和分娩方式。方法：收治妊娠合并血小板减少患者79例，回顾性分析其临床资料。结果：PAT与再生障碍性贫血患者的血小板水平在分娩后出现显著减少。9例患者采用自然分娩，分娩前PLT＞50×109/L 7例；55例患者采用了剖宫产，血小板水平下降至(50～100)×109/L 24例，剖宫产分娩16例；血小板水平下降至(20～50)×109/L 26例，剖宫产分娩24例；血小板水平下降至20×109/L 19例，剖宫产分娩18例。结论：PAT是导致妊娠合并血小板减少的主要原因，但其危害性较小，而ITP引起血小板减少伴有极大的危害性。在分娩方式的选择上，根据母体的血小板指数，一旦＜50×109/L时，以剖宫产的分娩方式为主。在母体的血小板指数＞50×109/L时，可考虑自然分娩。%Objective:To investigate the clinical manifestations,pathogenic factors and delivery mode of pregnancy complicated with thrombocytopenia.Methods:79 patients with pregnancy complicated with thrombocytopenia were selected,and the clinical data were retrospectively analyzed.Results:After delivery,the levels of platelets in patients with PAT and aplastic anemia were significantly decreased.9 patients were treated with natural labor,before delivery,PLT more than 50×109/L was in 7 cases.55 patients were treated with cesarean section,and the level of platelet was decreased to (50~100)×109/L in 24 cases,and 16 cases had cesarean section.The levels of blood platelets were decreased to (20~50)×109/L in 26 cases,24 cases had cesarean section. The level of blood platelet was decreased to 20×109/L in 19 cases,18 cases had cesarean section.Conclusion:PAT was the main reason for the decrease of pregnancy combined with thrombocytopenia,but it was less harmful,and ITP induced thrombocytopenia was a great harm.On the choice of delivery mode,according to the maternal platelet index,once it was below 50×109/L,cesarean section was the main mode of delivery.When the platelet index was higher than 50×109/L,the natural labor can be considered.