目的：探讨妊娠合并血小板减少症产妇剖宫产术麻醉方法的选择及其可行性和安全性。方法选择妊娠合并血小板减少症产妇90例，根据血小板计数分为 A 组（50×109／L ≤血小板计数＜100×109／L ，35例）、B 组（30×109／L ≤血小板计数＜50×109／L ，30例）和 C 组（血小板计数＜30×109／L ，25例）。其中 A 组和 B 组采取硬膜外麻醉方法，C 组选择全身麻醉。比较3组患者剖宫产术中出血量、术后并发症及新生儿 Apgar 评分。结果 A 组患者术中出血量为（437．8±110．3）ml ，B 组为（468．3±112．2）ml ，C 组为（485．5±115．7）ml ，3组患者术中出血量比较差异无统计学意义（ P ＞0．05）；A 组和 B 组新生儿产后1 min的 Apgar 评分均明显高于 C 组，差异有统计学意义（P ＜0．05），3组新生儿产后5 min 的 Apgar 评分比较无统计学意义（P ＞0．05）；3组患者均无严重并发症发生。结论妊娠合并血小板减少症产妇剖宫产术的麻醉方法应根据实际情况合理选择，血小板计数≥30×109／L 的产妇剖宫产术采取硬膜外麻醉是安全可行的。%Objective To explore the security and feasibility of anesthesia used in c - section of pregnant women with thrombopenia .Methods 90 pregnant women with thrombopenia were divided into 3 groups ac-cording to platelet count ,including A group(5 0 × 1 0 9 /L ≤ PLT < 1 0 0 × 1 0 9 /L ,3 5 patients) ,B group (3 0 × 1 0 L ≤ PLT < 5 0 × 1 0 9 /L ,3 0 patients) and C group (PLT < 3 0 × 1 0 9 /L ,2 5 patients) .The method of anesthesia in A and B groups was epidural anesthesia ,while general anesthesia was used in C group .Results There were no significant differences in intraoperative blood loss between 3 groups .Apgar scores at 1 min of A and B groups were all significantly higher than C group(P < 0 .0 5 ) .However ,no significant differences were found in Apgar scores at 5 min between 3 groups(P > 0 .0 5 ) .Furthermore ,no serious complications occurred in 3 groups .Con-clusions The method of anaesthesia in c - section of pregnant women with thrombopenia should be chosen ac -cording to the clinical situation .And epidural anesthesia used in c - section of pregnant women with thrombope-nia is security and feasible when PLT ≥ 3 0 × 1 0 9 /L .
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