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目的探讨妊娠期血小板减少的原因及临床处理方法。方法回顾性分析衢州市妇幼保健院2000~2005年间60例妊娠合并血小板减少患者临床资料。结果妊娠期血小板减少的患者中,75%(45例)为妊娠期血小板减少症(GT),15%(9例)为妊娠高血压综合征(PIH),5%(3例)为特发性血小板减少性紫癜(ITP),1例为系统性红斑狼疮(SLE),1例为药物性血小板减少性紫癜,1例为妊娠胆汁郁积症(ICP)。其中GT组不需特别处理,PIH组以糖皮质激素及输血小板为主,ITP组以糖皮质激素或免疫球蛋白(IVIG)为主,血小板<50×109/L时输注浓缩血小板。全部病例无孕产妇死亡或新生儿血小板减少。结论妊娠期血小板减少原因较多,应根据不同病因,采用不同的处理方法。
Objective To investigate the causes and clinical treatment of thrombocytopenia during pregnancy. Methods The clinical data of 60 pregnant women with thrombocytopenia in Quzhou MCH hospital from 2000 to 2005 were retrospectively analyzed. Results Among the patients with gestational thrombocytopenia, 75% (45 cases) were gestational thrombocytopenia (GT), 15% (9 cases) were PIH and 5% (3 cases) were idiopathic Thrombocytopenic purpura (ITP), 1 case of systemic lupus erythematosus (SLE), 1 case of drug-induced thrombocytopenic purpura and 1 case of pregnancy cholestasis (ICP). GT group did not need special treatment, PIH group mainly glucocorticoid and platelet transfusion, ITP group glucocorticoid or immunoglobulin (IVIG) mainly platelet transfusion <50 × 109 / L. No maternal deaths or neonatal thrombocytopenia were observed in all cases. Conclusion There are many reasons for thrombocytopenia during pregnancy, and different treatments should be taken according to different causes.