论文部分内容阅读
目的 探讨妊娠合并特发性血小板减少性紫癜 (idiopathicthrombocytopenicpurpura,ITP)围产期治疗效果及母儿结局。方法 回顾性分析我院 1994年 10月～ 2 0 0 3年 10月间妊娠合并ITP患者的临床资料 ,按照第二届全国血液病学术会议制定的ITP诊断标准。显效 :血小板计数 >10 0× 10 9/L ,良效 :血小板计数 (5 0～ 10 0 )× 10 9/L ,进步 :血小板计数比治疗前略有上升 ,无效 :血小板计数无变化。观察ITP患者给予糖皮质激素 (泼尼松 ) ,丙种球蛋白及 (或 )血小板悬液治疗后的临床效果及其母儿的围产结局。结果 妊娠合并ITP患者 92例 ,同期妊娠分娩数为 390 78例 ,发生率为 2 4‰。 34例伴有妊娠并发症 (34/ 92 ,37% ) ,其中妊娠高血压综合征 (妊高征 ) 7例 ,产后出血 6例 ,早产 9例 ,妊娠期糖耐量低减 19例 ,巨大儿 10例。阴道分娩 2 0例 (2 0 / 92 ,2 2 % ) ,剖宫产分娩 72例 (72 / 92 ,78% ) ,无孕产妇死亡。对其中 6 8例进行了孕期治疗 ,单纯糖皮质激素治疗 2 6例 ,糖皮质激素 +丙种球蛋白治疗 18例 ,糖皮质激素 +丙种球蛋白 +血小板悬液治疗 2 4例。 6 8例患者中 ,显效 4 2例 (42 / 6 8,6 2 % ) ,良效 16例 (16 / 6 8,2 4 % ) ,进步 8例 (8/ 6 8,12 % ) ,无效 2例 (2 / 6 8,3% )。 92例患者共分娩新?
Objective To investigate the effect of perinatal treatment and maternal and neonatal outcome of idiopathic thrombocytopenic purpura (ITP) in pregnancy. Methods The clinical data of ITP patients during pregnancy from October 1994 to October 2003 in our hospital were retrospectively analyzed. According to the diagnostic criteria of ITP established by the Second National Hematology Conference. Markedly: platelet count> 10 × 10 9 / L, good effect: platelet count (50 ~ 10 0) × 10 9 / L, progress: platelet count slightly higher than before treatment, invalid: no change in platelet count. To observe the clinical effect of ITP patients treated with glucocorticoid (prednisone), gamma globulin and (or) platelet suspension and their perinatal outcome. Results Ninety-two pregnant women with ITP were pregnant with 390 78 cases of pregnancy and childbirth in the same period, the incidence was 24%. 34 cases were accompanied by complications of pregnancy (34/92, 37%), including 7 cases of pregnancy induced hypertension (PIH), 6 cases of postpartum hemorrhage, 9 cases of premature delivery, gestational impaired glucose tolerance in 19 cases, macrosomia 10 cases. 20 cases were vaginal delivery (20/92, 22%), and 72 cases (72/92, 78%) were delivered by cesarean section without maternal death. Among them, 68 cases were treated during pregnancy. Glucocorticoid alone was used in 26 cases, glucocorticoid + gamma globulin in 18 cases, glucocorticoid + gamma globulin + platelet suspension in 24 cases. Sixty-eight patients (42/68, 62%) showed excellent results, 16 cases (16/68, 24%) showed good results, 8 cases (8/68, 12%) improved, 2 cases (2/6 8,3%). 92 patients were delivered new?