论文部分内容阅读
目的探讨胎盘早剥新生儿临床特征及凝血指标。方法选取2013年2月-2015年6月入住该院的67例胎盘早剥新生儿作为观察组,67例非胎盘早剥新生儿作为对照组,比较两组新生儿的临床资料及入院后和出院前活化部分凝血酶原时间(ATPP)、凝血酶原时间(PT)、纤维蛋白原(FBI)、D-二聚体(D-D)等凝血指标的变化。结果两组患儿性别、胎龄、出生体质量、休克比例差异无统计学意义(P>0.05),观察组贫血、酸中毒、电解质紊乱、缺氧性心肌损害,新生儿窒息所占比例显著高于对照组(P<0.05);观察组治愈率、住院时间、出院体质量显著低于对照组(P<0.05),死亡率显著高于对照组(P<0.05),好转率高于对照组,但差异无统计学意义(P>0.05);观察组患儿入院后ATPP、PT、D-D水平显著高于对照组,FBI水平显著低于对照组(P<0.05),出院前观察组ATPP、PT、D-D水平较入院后显著降低(P<0.05),FBI水平则较入院后显著升高(P<0.05),但与对照组比较差异无统计学意义(P>0.05)。结论贫血、酸中毒、电解质紊乱、缺氧性心肌损害、新生儿窒息为胎盘早剥新生儿基本临床特征,患儿较易继发凝血功能紊乱,呈病理性高凝状态,预后较差。
Objective To investigate the clinical features and coagulation indexes of neonates with placental abruption. Methods From February 2013 to June 2015, 67 infants with placental abruption admitted to the hospital were selected as observation group and 67 infants with non-placental abruption as control group. The clinical data of two groups were compared between the two groups after admission and The changes of some blood coagulation indexes such as partial prothrombin time (ATPP), prothrombin time (PT), fibrinogen (FBI) and D-dimer before discharge from hospital. Results There was no significant difference in sex, gestational age, birth weight and shock between the two groups (P> 0.05). The proportion of anemia, acidosis, electrolyte imbalance, hypoxic myocardial damage and neonatal asphyxia in the observation group was significant (P <0.05). The cure rate, length of hospital stay, discharge weight of the observation group were significantly lower than those of the control group (P <0.05), and the mortality rate was significantly higher than that of the control group (P <0.05) (P> 0.05). After admission, the levels of ATPP, PT and DD in the observation group were significantly higher than those in the control group, and the FBI levels were significantly lower in the observation group than in the control group (P <0.05) (P <0.05). The level of FBI was significantly higher than that after admission (P <0.05), but there was no significant difference between the two groups (P> 0.05). Conclusions Anemia, acidosis, electrolyte imbalance, hypoxic myocardial damage and neonatal asphyxia are the basic clinical features of neonates with placental abruption. Children with secondary coagulopathies tend to have coagulation disorders and appear hypercoagulable with poor prognosis.