前沿血小板减少症是指以血小板数量减少和或功能障碍导致凝血.DOCVIP

妊娠期首发血小板减少的临床诊断及原因分析 石琳 （湖北民族学院附属民大医院妇产科，湖北恩施445000） 作者简介：石琳（1974-），女，湖北恩施，本科，主治医师副主任。 摘要 目的：探讨妊娠期首发血小板减少的临床诊断特点并分析其原因。方法：对我院2001年12月至2011年12月符合标准的180例患者的临床资料进行回顾性分析，总结其病因分布、发病时间、血小板减少程度、分娩方式和产后出血以及产后恢复等情况。结果：（180例妊娠期首发血小板减少的患者中，妊娠期血小板减少症（GT）116（64.4%）（ITP ）47（26.1%）10例(5.5%),其中巨幼细胞性贫血（MA4例，再生障碍性贫血（AA3例，骨髓增生异常综合征（MDS3例。免疫系统疾病7例（3.8%）,其中系统性红斑狼疮（SLE）5（APS）2（2）116例GT患者中期、晚期出现血小板减少者分别为49例（42.3%）、53（45.7%）47例ITP患者早期、中期出现血小板减少者分别为15例（31.9%）22例（46.8%）。GTITP在发病时间上相比，差异有统计学意义（P=）。（3）GT患者血小板倾向于轻度、中度减少，分别为76例（65.5%）33例（28.4%）38例（80.8%（P=（4）113例轻度血小板减少患者，92例（81.4%3.5%；61例中度血小板减少者，48例（78.7%）采用了剖宫产，产后出血率为21.3%；6例重度血小板减少者均采用了剖宫产（100%），3例发生了产后出血。（5）：114（98.3%）10例（21.3%）ITP27例（57.4%）GT，其次为ITP，少见的病因包括血液系统疾病和免疫系统疾病。GT与ITP在血小板减少的程度、发病时间、对分娩方式的选择和产后出血、以及产后恢复情况上均有差异，准确的产前鉴别及诊断对临床工作有着重要的意义。 关键词 妊娠；血小板减少；临床诊断；鉴别 The clinical diagnosis and etiologic analysis of pregnancy-emerged thrombocytopenia SHI Lin （Department of Gynaecology and Obstetrics，MinDa Hospital Affiliated to Huibei Minzu College，Enshi 445000，China） Abstract Objective: To explore the etiology and clinical diagnosis of pregnancy-emerged thrombocytopenia. Methods: A retrospective analysis was conducted on clinical data of 180 patients, who match the standards of this research. The onset time of thrombocytopenia, platelet changes,maternal and perinatal outcomes as well as follow-up conditions were analyzed respectively based on the etiology. Results: (1)Etiology: among the 180 patients, 116 (64.4%) were diagnosed gestational thrombocytopenia (GT), 47 (26.1%) were idiopathic thrombocytopenia purpura (ITP), 10 (5.5%) were blood system diseases, including 4 cases of megaloblastic anemia (MA), 3 cases of aplastic anemia (AA), and 3 cases of myelodysplastic syndrome (MDS). 7 (3.8%) were immune system diseases, including 5 cases of systemic lupus erythematosus (SLE) and 2 cases of antiphospholipid syndrome (APS). (2) Onset time of thrombocytopenia: 49 cases (42.3%) and 53 cases (45.7%) were detected in second and third trimester amo