妊娠高血压综合征并发特发性血小板减少性紫癜患者临床分析.docVIP

妊娠高血压综合征并发特发性血小板减少性紫癜患者临床分析 　　[摘要] 目的:探讨妊娠高血压综合征(HIP)并发特发性血小板减少性紫癜(ITP)的围生期处理方法及母婴结局。方法:回顾性分析我院32例妊娠高血压综合征并发特发性血小板减少性紫癜患者的临床资料。结果:在治疗原发病的基础上,根据病情轻重不同采用糖皮质激素、血小板制剂、丙种球蛋白等治疗。其中,中期引产5例,阴道分娩13例,剖宫产14例,发生率为7.1%,胎死宫内1例。结论:糖皮质激素、血小板制剂、丙种球蛋白是治疗妊娠HIP并发ITP的有效方法,血小板计数50×109/L应在血源充分的情况下行剖宫产。 　　[关键词] 妊娠高血压综合征;紫癜;血小板减少性;特发性 　　[中图分类号] R714.25[文献标识码]A [文章编号]1673-7210(2010)05(a)-038-02 　　 　　Clinical analysis of pregnancy-induced hypertension syndrome complicated with idiopathic thrombocytopenic purpura in patients 　　YANG Qiao 　　(Department of Gynecology and Obstetrics, the Peoples Hospital of Wuchuan City, Wuchuan 524500, China) 　　[Abstract] Objective: To investigate pregnancy-induced hypertension syndrome (HIP) complicated with idiopathic thrombocytopenic purpura (ITP) of the perinatal outcome of treatment on mother and children. Methods: 32 cases of pregnancy-induced hypertension in our hospital syndrome complicated with idiopathic thrombocytopenic purpura in patients with clinical data were retrospectively analyzed. Results: In the treatment of primary disease, based on the severity of the different use of corticosteroids, platelet preparations, such as gamma globulin treatment. 5 cases in which the medium-term abortion, 13 cases of vaginal delivery, cesarean section in 14 cases, the incidence was 7.1%, fetal death in 1 case. Conclusion: Glucocorticoid, platelet preparations, gamma globulin treatment for pregnancy-HIP is an effective way to treat ITP, platelet count50×109/L should be full of blood downstream cesarean section. 　　[Key words] HIP; Purpura; Thrombocytopenic; Idiopathic 　　 　　妊娠特发性血小板减少性紫癜(ITP)是以外周血中血小板减少、骨髓巨核细胞数目正常或增多并伴有成熟障碍的免疫性疾病,可导致严重的出血倾向、产褥感染、新生儿颅内出血、胎儿窘迫甚至死胎,特别是HIP并发ITP时其围生期的处理更为复杂。为探讨HIP并发ITP的产科处理方法效果,笔者回顾性分析2004年3月～2009年9月32例我院收治的HIP并发ITP患者的临床资料,现报道如下: 　　1 资料与方法 　　1.1 一般资料 　　选择2004年3月～2009年9月我院妇产科收治的HIP并发ITP患者32例,其中,初产妇27例,经产妇5例;年龄23～38岁,平均年龄(27±3)岁;分娩孕周35～42周,平均(37±4)周。随机选择同期HIP产妇为保守组。ITP按照第二届全国血液病学术会议制订的诊断标准[1],HIP诊断标准参考《妇产科学》第7版。分治疗组和保守组进行分析。