1、妊娠合并血小板减少的临床分析摘 要 目的:分析妊娠合并血小板减少(Pregnancy with thrombocytopenia,PT )的原因及其对母婴预后的影响,为 PT 的预防及母婴结局的改善提供参考。方法:选取我院2013 年至 2016 年收治的 133 例 PT 患者作为观察组,并选取同期 100 名正常孕妇作为对照组,分析导致 PT 发生的危险因素。比较两组产妇母婴结局的差异,探讨 PT 对母婴结局的影响。结果:观察组年龄低于对照组,其产前贫血发生率、临床出血发生率高于对照组,差异有统计学意义(P0.05) 。随着产妇分娩前 PLT 的降低,其产后出血发生率逐渐升高,组间差异有统
2、计学意义(P50109/L 的 PT 患者,其新生儿结局与正常组比较,差异无统计学意义(P0.05) ;PLT50109/L 的 PT 患者,随着其 PLT 的降低,新生儿双顶径、体质量、1 min Apgar 评分逐渐下降,宫内窘迫率、发育迟缓率逐渐升高,差异有统计学意义(P50109/L 的 PT 患者,其新生儿结局与正常组比较,差异无统计学意义(P0.05) ;PLT50109/L 的 PT患者,随着其 PLT 的降低,新生儿双顶径、体质量、1 min Apgar 评分逐渐下降,宫内窘迫率、发育迟缓率逐渐升高,差异有统计学意义(P50109/L 患者而言,一般无需实施特殊治疗,但应密切监
3、测其 PLT 水平变化;若患者PLT 处于 2050109/L 范围内,可行提高血小板治疗,治疗方案包括治疗原发病以及应用糖皮质激素、人免疫球蛋白、血小板制剂等;若患者 PLT 年龄较低的产妇更易发生 PT,且多合并产前贫血、临床出血症状,PT 的高危因素主要包括 PAT、ITP 等,随着产妇 PLT 的降低,母婴结局逐渐恶化,因此,应早期鉴别 PT 产妇病因并实施针对性干预。 参 考 文 献 1 Xu X, Liang M, Wang J, et al. Clinical features and outcome of pregnancy with SLE-associated thromb
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