中华妇幼临床医学杂志（电子版）
中華婦幼臨床醫學雜誌（電子版）
중화부유림상의학잡지（전자판）
CHINESE JOURNAL OF OBSTETRICS & GYNECOLOGY AND PEDIATRICS(ELECTRONIC VERSION)
2014年
6期
793-796
,共4页
妊娠%血小板减少%妊娠合并症%妊娠结局
妊娠%血小闆減少%妊娠閤併癥%妊娠結跼
임신%혈소판감소%임신합병증%임신결국
Pregnancy%Thrombocytopenia%Pregnancy complications%Pregnancy outcome
目的：探讨妊娠相关性血小板减少症(PAT)患者的临床特点。方法选择2012年1月至2013年12月在自贡市第一人民医院产科分娩的60例 PAT 患者为研究对象,纳入血小板减少组(妊娠期检查发现2次以上血小板计数<100×109/L)。选择同期在同一家医院分娩的60例正常孕妇纳入血小板正常组(血小板计数≥100×109/L)。采用回顾性分析方法,比较两组孕妇的分娩方式、麻醉方式、产前凝血功能、产时出血量及所产新生儿出生时情况,并观察血小板减少组患者治疗情况、产后血小板恢复情况等。本研究遵循的程序符合自贡市第一人民医院人体试验委员会制定的伦理学标准,得到该委员会批准,分组征得受试对象知情同意,并与之签署临床研究知情同意书。两组孕妇年龄、分娩孕龄及初产妇与经产妇所占比例等比较,差异均无统计学意义(P >0.05)。结果①两组孕妇分娩方式及剖宫产时麻醉方式构成比比较,差异均有统计学意义(χ2=29.40,42.57；P <0.05)。血小板减少组分娩方式以剖宫产为主,并且其中剖宫产分娩者的麻醉方式以全身麻醉为主。血小板正常组分娩方式以阴道分娩为主,其中剖宫产分娩者的麻醉方式全部采用持续硬膜外麻醉或蛛网膜下腔麻醉。②血小板减少组孕妇剖宫产率及剖宫产时全身麻醉率均有随血小板减少程度增加而增加的趋势(χ2=3.11,P =0.04；χ2=17.51,P =0.00)。③两组孕妇产前凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FG)和阴道分娩及剖宫产产时出血量比较,差异均无统计学意义(t=1.24,1.61,0.42,0.93,1.58；P >0.05)。④两组孕妇所产新生儿出生体质量及血小板计数比较,差异均无统计学意义(t=0.860,1.206；P >0.05)。⑤本组血小板减少组孕妇产前及产后未做特殊治疗,血小板计数最短于产后24 h,最长于产后3周恢复正常。结论PAT 患者产前及产后均不需特殊治疗,产后1~3周血小板计数可自行恢复正常。
目的：探討妊娠相關性血小闆減少癥(PAT)患者的臨床特點。方法選擇2012年1月至2013年12月在自貢市第一人民醫院產科分娩的60例 PAT 患者為研究對象,納入血小闆減少組(妊娠期檢查髮現2次以上血小闆計數<100×109/L)。選擇同期在同一傢醫院分娩的60例正常孕婦納入血小闆正常組(血小闆計數≥100×109/L)。採用迴顧性分析方法,比較兩組孕婦的分娩方式、痳醉方式、產前凝血功能、產時齣血量及所產新生兒齣生時情況,併觀察血小闆減少組患者治療情況、產後血小闆恢複情況等。本研究遵循的程序符閤自貢市第一人民醫院人體試驗委員會製定的倫理學標準,得到該委員會批準,分組徵得受試對象知情同意,併與之籤署臨床研究知情同意書。兩組孕婦年齡、分娩孕齡及初產婦與經產婦所佔比例等比較,差異均無統計學意義(P >0.05)。結果①兩組孕婦分娩方式及剖宮產時痳醉方式構成比比較,差異均有統計學意義(χ2=29.40,42.57；P <0.05)。血小闆減少組分娩方式以剖宮產為主,併且其中剖宮產分娩者的痳醉方式以全身痳醉為主。血小闆正常組分娩方式以陰道分娩為主,其中剖宮產分娩者的痳醉方式全部採用持續硬膜外痳醉或蛛網膜下腔痳醉。②血小闆減少組孕婦剖宮產率及剖宮產時全身痳醉率均有隨血小闆減少程度增加而增加的趨勢(χ2=3.11,P =0.04；χ2=17.51,P =0.00)。③兩組孕婦產前凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)、纖維蛋白原(FG)和陰道分娩及剖宮產產時齣血量比較,差異均無統計學意義(t=1.24,1.61,0.42,0.93,1.58；P >0.05)。④兩組孕婦所產新生兒齣生體質量及血小闆計數比較,差異均無統計學意義(t=0.860,1.206；P >0.05)。⑤本組血小闆減少組孕婦產前及產後未做特殊治療,血小闆計數最短于產後24 h,最長于產後3週恢複正常。結論PAT 患者產前及產後均不需特殊治療,產後1~3週血小闆計數可自行恢複正常。
목적：탐토임신상관성혈소판감소증(PAT)환자적림상특점。방법선택2012년1월지2013년12월재자공시제일인민의원산과분면적60례 PAT 환자위연구대상,납입혈소판감소조(임신기검사발현2차이상혈소판계수<100×109/L)。선택동기재동일가의원분면적60례정상잉부납입혈소판정상조(혈소판계수≥100×109/L)。채용회고성분석방법,비교량조잉부적분면방식、마취방식、산전응혈공능、산시출혈량급소산신생인출생시정황,병관찰혈소판감소조환자치료정황、산후혈소판회복정황등。본연구준순적정서부합자공시제일인민의원인체시험위원회제정적윤리학표준,득도해위원회비준,분조정득수시대상지정동의,병여지첨서림상연구지정동의서。량조잉부년령、분면잉령급초산부여경산부소점비례등비교,차이균무통계학의의(P >0.05)。결과①량조잉부분면방식급부궁산시마취방식구성비비교,차이균유통계학의의(χ2=29.40,42.57；P <0.05)。혈소판감소조분면방식이부궁산위주,병차기중부궁산분면자적마취방식이전신마취위주。혈소판정상조분면방식이음도분면위주,기중부궁산분면자적마취방식전부채용지속경막외마취혹주망막하강마취。②혈소판감소조잉부부궁산솔급부궁산시전신마취솔균유수혈소판감소정도증가이증가적추세(χ2=3.11,P =0.04；χ2=17.51,P =0.00)。③량조잉부산전응혈매원시간(PT)、활화부분응혈활매시간(APTT)、섬유단백원(FG)화음도분면급부궁산산시출혈량비교,차이균무통계학의의(t=1.24,1.61,0.42,0.93,1.58；P >0.05)。④량조잉부소산신생인출생체질량급혈소판계수비교,차이균무통계학의의(t=0.860,1.206；P >0.05)。⑤본조혈소판감소조잉부산전급산후미주특수치료,혈소판계수최단우산후24 h,최장우산후3주회복정상。결론PAT 환자산전급산후균불수특수치료,산후1~3주혈소판계수가자행회복정상。
Objective To investigate clinical features of pregnancy associated thrombocytopenia (PAT).Methods A total of 60 PAT pregnant women who delivered in Zigong First Hospital from January 2012 to December 2013 were bringing into thrombocytopenia group (more than twice detection results showed platelet count< 100 × 10 9/L during pregnancy).Meanwhile,other 60 normal pregnant women who delivered at same hospital were bringing into platelet count normal group(platelet count≥100×10 9/L during pregnancy).All clinical data were analyzed by retrospective method,including delivery way,anaesthesia, prenatal coagulative function,amount of intrapartum hemorrhage,and neonatal birth conditions were compared between two groups.The treatments and recover conditions of platelet after delivery were also observed in thrombocytopenia group.The study protocol was approved by the Ethical Review Board of Investigation of Zigong First Hospital.Informed consent was obtained from each participant.There were no significant differences between two groups in age ,delivery gestational age of pregnant woman and percentage of primiparous and multiparous(P > 0.05 ).Results ① The constituent ratio of delivery ways and anaesthesia modes between two groups had statistically differences (χ2 = 29.40,42.57;P < 0.05 ). Caesarean section was the main delivery way in thrombocytopenia group and general anaesthesia was used in the most cases during caesarean section.Vaginal delivery was reliable in the most cases in platelet count normal group and epidural or subarachnoid anaesthesia were used in whom chosed caesarean section.②Caesarean section rate and general anaesthesia rate were increased following by decreasing degree of platelet count in thrombocytopenia group (χ2 = 3.1 1,P = 0.04;χ2 = 1 7.5 1,P = 0.00 ).③ There were no statistically differences between two groups in prothrombin time(PT),activated partial thromboplastin time (APTT)and fibrinogen(FG)before delivery,and blood loss volume during vaginal delivery or caesarean section(t=1.24,1.61,0.42,0.93,1.58;P >0.05).④There were no statistically differences between two groups in neonatal birth weight and platelet count(t = 0.860,1.206;P > 0.05 ).⑤ There were no specific treatment before and after delivery in thrombocytopenia group,and platelet count return to normal in 24 hours to 3 weeks after delivery.Conclusions PAT pregnant women don′t need specific treatment before and after delivery,and platelet count can automatically return to normal about one to three weeks after delivery.
