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目的探讨维生素K选择性应用在预防婴儿维生素K缺乏症的临床效果。方法采用胶乳凝集半定量法对90例婴儿脐血血浆异常凝血酶原(PIVKA-Ⅱ)阳性状况进行筛检。实验组(选择性维生素K1干预组)45例纯母乳喂养婴儿根据检测结果,采用不同剂量、不同疗程、不同方式的维生素K予以选择性补充;对照组(常规维生素K1干预组)45例纯母乳喂养婴儿采用一次性肌注维生素K11mg的常规方法补充。至出生后第45、90天时复查血浆PIVKA-Ⅱ浓度,观察结果。结果90例婴儿中有42例脐血PIVKA-Ⅱ呈阳性,阳性率为46·7%。实验组和对照组脐血PIV-KA-Ⅱ阳性者分别为19例、23例,阳性率分别为42·2%、51·1%(χ2=0·71,P>0·05)。干预后实验组和对照组出生45、90d时血浆PIVKA-Ⅱ阳性发生率分别降为0%、33·3%(χ2=18·00,P<0·001)和0%、15·6%(χ2=5·58,P<0·05)。经脐血筛查后选择性补充维生素K1的干预方法,明显优于常规一次性肌注维生素K1的干预方法。结论维生素K选择性应用对母乳喂养婴儿维生素K缺乏症的预防效果满意。
Objective To explore the clinical effect of selective vitamin K in preventing infant vitamin K deficiency. Methods Ninety cases of cord blood plasma prothrombin (PIVKA-Ⅱ) positive status were screened by latex agglutination semi-quantitative method. In the experimental group (selective vitamin K1 intervention group), 45 cases of exclusive breastfeeding infants were selectively supplemented with vitamin K with different dosages, different courses and different ways according to the test results. In the control group (routine vitamin K1 intervention group), 45 cases of exclusive breast milk Infants fed a one-time intramuscular vitamin K11mg conventional method of supplement. To 45,90 days after birth, review of plasma PIVKA-Ⅱ concentration, the observation results. Results Among the 90 infants, 42 cases of cord blood PIVKA-Ⅱ positive, the positive rate was 46.7%. The positive rates of PIV-KA-Ⅱ in cord blood of experimental group and control group were 19 and 23, respectively, the positive rates were 42.2% and 51.1% respectively (χ2 = 0.71, P> 0.05). After the intervention, the positive rates of PIVKA-Ⅱ in experimental group and control group were decreased to 0%, 33.3% (χ2 = 18.00, P <0.001) and 0%, 15.6% (χ2 = 5.58, P <0.05). The screening method of selective vitamin K1 supplementation after cord blood screening is significantly better than the conventional one-time intramuscular vitamin K1 intervention. Conclusion The selective use of vitamin K is satisfactory for the prevention of vitamin K deficiency in breastfeeding infants.