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目的探讨新生儿血小板减少症的病因、临床特点及治疗措施。方法对75例新生儿血小板减少症进行回顾性分析。其中男51例,女24例;日龄0～7d43例,>7～28d32例;早产儿24例,足月儿49例,过期产儿2例;顺产56例,剖宫产19例。宫内窘迫史18例;轻度窒息12例,重度窒息3例。积极抗感染治疗原发病,疗效不佳者予静脉输注丙种球蛋白、氢化可的松。治疗前后测定血小板计数。结果75例中新生儿肺炎62例(占82.7%),新生儿败血症31例(占41.3%),新生儿坏死性小肠结肠炎3例(占4.0%);宫内窘迫、生后窒息共33例(占44.0%);RDS、母亲妊娠高血压综合征、寒冷损伤综合征、血液及出血性疾病等也是临床常见的高危因素。43例经抗感染治疗后血小板恢复正常。21例予静脉输注丙种球蛋白,其中4例加用氢化可的松后血小板恢复正常。6例放弃治疗,5例症状好转血小板未恢复正常出院。临床治愈64例(85.3%)。治愈天数(7.23±4.09)d。结论感染是新生儿血小板减少症的最主要因素,病因治疗是关健。应动态监测、及时处理,防止严重并发症和后遗症发生。
Objective To investigate the etiology, clinical features and treatment of neonatal thrombocytopenia. Methods 75 cases of neonatal thrombocytopenia were retrospectively analyzed. There were 51 males and 24 females. There were 43 cases of 0-7 days old and> 7-28 days of age. There were 24 preterm infants, 49 full-term infants and 2 expired infants. There were 56 males and 19 caesareans. 18 cases of intrauterine distress history; 12 cases of mild asphyxia, severe asphyxia in 3 cases. Positive anti-infection treatment of the primary disease, poor efficacy of intravenous infusion of gamma globulin, hydrocortisone. Platelet count was measured before and after treatment. Results 75 cases of neonatal pneumonia in 62 cases (82.7%), neonatal sepsis in 31 cases (41.3%), neonatal necrotizing enterocolitis in 3 cases (4.0%); intrauterine distress, postpartum asphyxia a total of 33 Cases (44.0%); RDS, maternal pregnancy-induced hypertension syndrome, cold injury syndrome, blood and bleeding disorders are also common clinical risk factors. 43 cases of anti-infective platelets returned to normal. 21 cases were given intravenous gamma globulin, of which 4 cases with hydrocortisone platelet returned to normal. 6 cases to give up treatment, 5 cases of symptoms improved platelet did not resume normal discharge. Clinical cure 64 cases (85.3%). Cure days (7.23 ± 4.09) d. Conclusion Infection is the most important factor of neonatal thrombocytopenia. Etiology treatment is the key factor. Should be dynamically monitored and promptly treated to prevent serious complications and sequelae.