免疫性血小板减少症妊娠期治疗相关并发症研究
发布时间：2019-03-04 09:26
【摘要】：目的探讨妊娠期免疫性血小板减少症(immune thrombocytopenia,ITP)母体干预治疗对母儿并发症及妊娠结局的影响。方法选择2009年1月到2016年1月北京大学人民医院产科收治的血小板计数有两次或以上30×10~9/L妊娠期ITP 119例,给予系统孕期保健,根据不同治疗方法分为单独糖皮质激素组(33例)、丙种球蛋白组(8例)、激素联合丙球组(26例)和支持治疗组(52例)4组。比较各组相关母体并发症、分娩结局、新生儿和随访情况。结果 119例患者中,糖皮质激素治疗开始孕周20~35孕周,用药时间1~15周。丙种球蛋白治疗开始孕周16~36周,周期1~5个疗程。妊娠期高血压疾病(HDP)13例(10.9%),妊娠期糖尿病(GDM)18例(15.1%),贫血39例(32.8%),早产24例(20.2%),胎膜早破8例(6.7%);产后出血33例(27.7%),产褥感染1例(0.8%),无重要脏器自发出血及孕产妇死亡。4组在HDP与早产的发生率比较,差异有统计学意义(P0.05)。激素治疗组与无激素治疗组HDP、GDM和早产发生率比较,差异有统计学意义(P0.05),但两组36周早产率比较,差异无统计学意义(P0.05)。终止妊娠孕周30~(+6)~40~(+5)周。剖宫产76例(63.9%)。围生儿119例,活产儿116例,死胎3例:无死产及新生儿死亡。新生儿血小板减低16例(13.4%),头颅血肿1例。结论妊娠期ITP患者经合理干预可获得满意妊娠结局。激素治疗可导致HDP、GDM等相关并发症增加,应注意适应证及监测母体血压、血糖变化。
[Abstract]:Objective to investigate the effect of maternal intervention on maternal and fetal complications and pregnancy outcome in patients with immune thrombocytopenia during pregnancy (immune thrombocytopenia,ITP). Methods from January 2009 to January 2016, there were two or more platelet counts in the obstetrics department of Peking University people's Hospital, including 30 脳 10 ~ 9 渭 L ITP during pregnancy, and all patients were given systemic care during pregnancy. According to different treatment methods, they were divided into four groups: glucocorticoid alone group (33 cases), immunoglobulin group (8 cases), hormone combined with propranolol group (26 cases) and support treatment group (52 cases). Maternal complications, delivery outcomes, newborns and follow-up were compared in each group. Results in 119 patients, glucocorticoid treatment began at 20-35 weeks, and the treatment lasted for 1-15 weeks. Gamma globulin treatment began to gestation weeks 16 weeks 36 weeks, cycle 1 and 5 courses. There were 13 cases of hypertensive disorder complicating pregnancy (HDP) (10.9%), 18 cases of gestational diabetes mellitus (GDM) (15.1%), 39 cases of anemia (32.8%), 24 cases of premature delivery (20.2%), 8 cases of premature rupture of membranes (6.7%). There were 33 cases of postpartum hemorrhage (27.7%), 1 case of puerperal infection (0.8%), no spontaneous hemorrhage of important organs and maternal mortality. There was significant difference in the incidence of HDP and premature delivery among the 4 groups (P0.05). There was a significant difference in the incidence of HDP,GDM and preterm delivery between hormone treatment group and non-hormone treatment group (P0.05), but there was no significant difference between the two groups in 36-week premature birth rate (P0.05). 30 ~ (6) ~ 40 ~ (5) weeks after termination of pregnancy. 76 cases (63.9%) were cesarean section. There were 119 perinatal infants, 116 live births and 3 dead fetuses: no stillbirth and neonatal death. Thrombocytopenia was found in 16 cases (13.4%) and hematoma in 1 case. Conclusion satisfactory pregnancy outcome can be obtained by reasonable intervention in pregnant patients with ITP. Hormone therapy can lead to HDP,GDM and other related complications, should pay attention to indications and monitor maternal blood pressure, blood glucose changes.
【作者单位】： 北京大学人民医院妇产科;
【分类号】：R714.254
本文编号：2434153
[Abstract]:Objective to investigate the effect of maternal intervention on maternal and fetal complications and pregnancy outcome in patients with immune thrombocytopenia during pregnancy (immune thrombocytopenia,ITP). Methods from January 2009 to January 2016, there were two or more platelet counts in the obstetrics department of Peking University people's Hospital, including 30 脳 10 ~ 9 渭 L ITP during pregnancy, and all patients were given systemic care during pregnancy. According to different treatment methods, they were divided into four groups: glucocorticoid alone group (33 cases), immunoglobulin group (8 cases), hormone combined with propranolol group (26 cases) and support treatment group (52 cases). Maternal complications, delivery outcomes, newborns and follow-up were compared in each group. Results in 119 patients, glucocorticoid treatment began at 20-35 weeks, and the treatment lasted for 1-15 weeks. Gamma globulin treatment began to gestation weeks 16 weeks 36 weeks, cycle 1 and 5 courses. There were 13 cases of hypertensive disorder complicating pregnancy (HDP) (10.9%), 18 cases of gestational diabetes mellitus (GDM) (15.1%), 39 cases of anemia (32.8%), 24 cases of premature delivery (20.2%), 8 cases of premature rupture of membranes (6.7%). There were 33 cases of postpartum hemorrhage (27.7%), 1 case of puerperal infection (0.8%), no spontaneous hemorrhage of important organs and maternal mortality. There was significant difference in the incidence of HDP and premature delivery among the 4 groups (P0.05). There was a significant difference in the incidence of HDP,GDM and preterm delivery between hormone treatment group and non-hormone treatment group (P0.05), but there was no significant difference between the two groups in 36-week premature birth rate (P0.05). 30 ~ (6) ~ 40 ~ (5) weeks after termination of pregnancy. 76 cases (63.9%) were cesarean section. There were 119 perinatal infants, 116 live births and 3 dead fetuses: no stillbirth and neonatal death. Thrombocytopenia was found in 16 cases (13.4%) and hematoma in 1 case. Conclusion satisfactory pregnancy outcome can be obtained by reasonable intervention in pregnant patients with ITP. Hormone therapy can lead to HDP,GDM and other related complications, should pay attention to indications and monitor maternal blood pressure, blood glucose changes.
【作者单位】： 北京大学人民医院妇产科;
【分类号】：R714.254
【相似文献】
相关期刊论文 前2条
1 朱松青;曲旬;;妊娠期高血压疾病肝肾功能变化的临床观察[J];中国煤炭工业医学杂志;2006年08期
2 杨春芳;任雁林;姬宏宇;任雁林;姬宏宇;;妊娠期高血压疾病合并Moyamoya病及脑动脉瘤1例[J];山西医科大学学报;2014年05期
，本文编号：2434153
本文链接：https://www.wllwen.com/yixuelunwen/fuchankeerkelunwen/2434153.html
最近更新
教材专著
