CAJ | 학술논문

目的：探讨妊娠合并特发性血小板减少性紫癜的治疗及对妊娠结局的影响。方法回顾性分析妊娠合并特发性血小板减少性紫癜62例患者临床资料。结果62例患者中剖宫产25例，产后出血4例，产后出血发生率为16.0%；阴道分娩37例，产后出血6例，发生率16.2%。单纯糖皮质激素治疗39例，糖皮质激素联合丙种球蛋白治疗4例，联合治疗血小板仍持续下降给予输注血小板治疗6例。新生儿外周血血小板计数＜100×109/L者7例，无颅内出血、内脏出血及其他相关出血性疾病，且血小板计数均于1周内恢复正常。结论糖皮质激素、糖皮质激素联合丙种球蛋白及血小板输注是治疗妊娠合并ITP孕妇安全有效的方法，分娩方式选择由产科情况决定。两种分娩方式产后出血率无明显差异，虽产后出血率增加，但对围生儿结局无不良影响。
목적：탐토임신합병특발성혈소판감소성자전적치료급대임신결국적영향。방법회고성분석임신합병특발성혈소판감소성자전62례환자림상자료。결과62례환자중부궁산25례，산후출혈4례，산후출혈발생솔위16.0%；음도분면37례，산후출혈6례，발생솔16.2%。단순당피질격소치료39례，당피질격소연합병충구단백치료4례，연합치료혈소판잉지속하강급여수주혈소판치료6례。신생인외주혈혈소판계수＜100×109/L자7례，무로내출혈、내장출혈급기타상관출혈성질병，차혈소판계수균우1주내회복정상。결론당피질격소、당피질격소연합병충구단백급혈소판수주시치료임신합병ITP잉부안전유효적방법，분면방식선택유산과정황결정。량충분면방식산후출혈솔무명현차이，수산후출혈솔증가，단대위생인결국무불량영향。
Objective To investgate the management and the pregnancy outcomes of pregnant women with Idiopathic Thrombocytopenic Purpura (ITP). Methods Analysis the clinical data of 62 pregnanacies with ITP retrospectively. Results Among the 62 cases, cesarean section and vaginal delivery were performed in 25 and 37 cases respectively. 4 (16.0%) cases of postpartum hemorrhage happened after cesarean section and 6(16.2%) cases after vaginal delivery.39,4 and 6 cases were cured by glucocorticoids, glucocorticoids plus gamma globulin and transfusion of platelets respectively. Totally,7 cases of the newborn blood platelet count were less than 100×109/L and the count recovered to normal within one week.No intracranial hemorrhage, internal bleeding and other related bleeding disorders occurred. Conclusion Glucocorticoids, gamma globulin and transfusion of platelets are effective and safe for the treatment of ITP during pregnancy.The mode of delivery is determined by obstetrical considerations. The rate of postpartum hemorrhage had no significant difference between two delivery methods. Although the rate of postpartum hemorrhage increased compared with normal pregnancy,it had no adverse effects on the outcomes of perinatal infant.