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目的探讨妊娠合并血小板减少症的病因及对母婴结局的影响。方法回顾性分析妊娠合并血小板减少症患者96例,并根据孕期血小板计数分为4组,Ⅰ组患者血小板计数为50×10~9~100×10~9/L,Ⅱ组患者血小板计数为30×10~9~50×10~9/L,Ⅲ组患者血小板计数为10×10~9~30×10~9/L,Ⅳ组患者血小板计数低于10×10~9/L。比较各组患者的疾病病因、妊娠期并发症及母婴分娩情况。结果 96例妊娠合并血小板减少症患者中,病因主要包括血小板减少症、特发性血小板减少性紫癜、妊娠期高血压疾病、再生障碍性贫血、系统性红斑狼疮,其中特发性血小板减少性紫癜、妊娠期高血压疾病在4组中发生率具有统计学意义(P<0.05);妊娠期高血压疾病、早产及产后出血在4组中的发生率具有统计学意义(P<0.05);4组围生儿足月低体重儿,颅内出血以及围生儿死亡率无统计学意义(P>0.05);4组间新生儿血小板减少发生率具有统计学意义(P<0.05),母体血小板数目越少,新生儿血小板减少发生率越高。结论妊娠合并血小板减少症病因复杂,且患者血小板数目越少,发生妊娠期高血压疾病、早产、产后出血及新生儿血小板减少比例越高。
Objective To investigate the etiopathogenisis of pregnancy with thrombocytopenia and its effect on maternal and infant outcomes. Methods A total of 96 pregnant women with thrombocytopenia were analyzed retrospectively. According to the platelet count in pregnancy, the platelet count was 50 × 10 ~ 9 ~ 100 × 10 ~ 9 / L. The platelet count in group Ⅱ was 30 × 10 ~ 9 ~ 50 × 10 ~ 9 / L, platelet count in group Ⅲ was 10 × 10 ~ 9 ~ 30 × 10 ~ 9 / L, and platelet count in group Ⅳ was less than 10 × 10 ~ 9 / L. The causes of disease, complications during pregnancy and maternal and childbirth were compared between groups. Results 96 cases of pregnancy with thrombocytopenia in patients with etiology include thrombocytopenia, idiopathic thrombocytopenic purpura, gestational hypertension, aplastic anemia, systemic lupus erythematosus, idiopathic thrombocytopenic purpura (P <0.05). The prevalence rates of gestational hypertension, premature labor and postpartum hemorrhage in 4 groups were statistically significant (P <0.05); 4 There was no significant difference in perinatal neonates with full-term and low-weight infants, intracranial hemorrhage and perinatal mortality (P> 0.05). The incidence of neonatal thrombocytopenia was statistically significant (P <0.05), the number of maternal platelets The less, the higher the incidence of neonatal thrombocytopenia. Conclusions The causes of pregnancy complicated with thrombocytopenia are complicated, and the less the number of patients with platelets, the incidence of gestational hypertension, the higher the proportion of premature delivery, postpartum hemorrhage and neonatal thrombocytopenia.