妊娠相关血小板减少症和妊娠合并特发性血小板减少性紫癜的对比探讨

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1、妊娠相关血小板减少症和妊娠合并特发性血小板减少性紫癜的对比探讨李莉谢静秋(成都市青羊区妇幼保健院四川成都610000)【屮图分类号】R714.25【文献标识码】A【文章编号】2095-1752(2011)23-0145-02【摘要】目的探讨妊娠相关血小板减少症(PAT)和妊娠合并特发性血小板减少性紫癜(PCITP)的鉴别，寻找最佳的处理方法。方法对在成都市青羊区妇幼保健院2000年1月至2010年12月收治的妊娠相关血小板减少症和妊娠合并特发性血小板减少性紫癜69例进行回顾性分析，对其发生时期、处理方法、妊娠结局进行回顾性分析。结果PAT一般发生在妊娠屮晚期。血小板计数多大于50&time

2、s;109/l,多在产后一周恢复正常。一般不需要特殊处理。PCITP多发生在孕前和妊娠早期，血小板减小程度较重，PCITP组剖宫产率和产后出血率较PAT组均有显著差异，血小板小于50×109/l,有明显出血倾向或紧急手术前，可输血小板。分娩方式视血小板多少有无产科指征而定。结论ATP和PCITP各有其特点，不同病因可导致妊娠合并血小板减少，视血小板减少的轻重程度而采取不同处理。【关键词】妊娠相关血小板减少症妊娠合并特发性血小板减少性紫癜【Abstract】objective:Theobjectiveofthisresearchistoexploretheidentificati

3、onofpregnancyassociatedthrombocytopenia(PAT)andpregnancycomplicatedwithidiopathicthrombocytopenicpurpura(PCITP),andtofindoptimumtreatment.Methods:clinicaldataof69casesofpregnancyassociatedthrombocytopeniaandpregnancycomplicatedwithidiopathicthrombocytopenicpurpurawereretrospectivelyreviewedduringJ

4、anuary2000toDecember2010ChengduQingyangDistrictMaternalandChildHealthHospital.Thetermofoccurrenceofthrombocytopeniaaswellastreatmentmethodsofthrombocytopeniaandoutcomesofpregnancywereanalyzedretrospectively.Results:PATusuallyoccursinlatepregnancy,plateletcoutisusuallymorethan50X109/1andrecoveredto

5、normalinoneweekafterdelivery.PATgenerallydonotneedspecialtreatment.PCITPoccursbeforebeingpregnantandthepregnancyearlytime,thebloodplateletreductiondegreeisheavy.cesareansectioreateandthepostportumhemorrhagerateinthePCITPgroupcomparewithofPATgrouphaveremarkabledifference.plateletwasgiventothosewith

6、platelatcountlessthan50X109/1forobviousbleedingtendencyoremergencyoperation.Themethodofdeliverydependedonplateletnumberandobstetricindication.Conclusion:PATandPCITPhaverespectivecharateristics.Thevariouscausemayleadthrombocytopeniawhihpregnancy.Thedifferentmanagementisgiveninaccordingtodifferentet

7、iology.【Keywords]pregnancyassociatedthrombocytopenia;pregnancycomplicatedwithidiopathicthrombocytopenicpurpura妊娠合并血小板减少对母婴危害较大。该病以出血、贫血和感染为特点，可导致产后出血、新生儿颅内出血等。血小板减少在妊娠中的发生率为7.6%,其中妊娠相关血小板减少症(pregnancyassociatedth