论文部分内容阅读
目的:探讨不同胎龄早产儿凝血功能状态及低纤维蛋白原输注冷沉淀后的疗效分析。方法:①选择126例早产儿,按胎龄分为<32孕周组、≥32～<35孕周组、≥35～37孕周组,设50例正常足月新生儿为对照组,在出生后的24h内检测凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)及血小板计数(PLT),分析早产儿凝血功能状态。②对其中55例纤维蛋白原浓度低于0.8g/L的早产儿进行冷沉淀输注,输注完2h内测定FIB、PT、APTT、TT、D-D及PLT,并与输注前进行比较分析。结果:①与对照组比较,早产儿PT、APTT、TT明显增高(P<0.01),FIB明显降低(P<0.01),D-D增高(P<0.05),PLT差异无统计学意义(P>0.05)。②<32孕周组与≥35～37孕周组比较PT、APTT、TT、D-D增高(P<0.05),FIB降低(P<0.05),PLT无明显差异(P>0.05)。③55例早产儿输注冷沉淀后FIB明显增高(P<0.01),PT、APTT降低(P<0.05),TT、D-D差异无统计学意义(P>0.05)。结论:早产儿凝血功能比正常足月新生儿低下,胎龄越低凝血功能障碍越严重,临床应尽早重视其凝血功能状态;对纤维蛋白原浓度低于0.8g/L的早产儿应尽早输注冷沉淀,在改善早产儿预后及提高成活率方面具有积极的临床意义。
Objective: To investigate the effect of coagulation status and hypofibrinogen infusion after cryoprecipitation in preterm infants of different gestational ages. Methods: 126 cases of preterm infants were selected and divided into gestational age group <32 gestational weeks, group of ≥32 ~ <35 gestational weeks, group of 35-37 gestational weeks, and 50 normal term newborns as control group. Thrombin time (PT), APTT, TT, fibrinogen (FIB), D-dimer (DD) PLT), analysis of coagulation function in preterm children. (2) 55 preterm infants with fibrinogen concentration less than 0.8g / L were cryoprecipitated, FIB, PT, APTT, TT, DD and PLT were determined within 2h after infusion, and compared with pre-infusion . Results: ① Compared with the control group, PT, APTT and TT in preterm infants were significantly increased (P <0.01), FIB was significantly lower (P <0.01), DD was higher (P <0.05), PLT had no statistical significance ). ② The levels of PT, APTT, TT and D-D in <32 gestational weeks group and those in 35 ~ 37 gestational weeks group increased (P <0.05), FIB decreased (P <0.05), PLT had no significant difference (P> 0.05). ③ The FIB of 55 premature infants after infusion of cryoprecipitation increased significantly (P <0.01), PT and APTT decreased (P <0.05), TT and D-D had no statistical significance (P> 0.05). Conclusion: The coagulation function in premature infants is lower than that in normal full - term newborns. The lower the gestational age, the more severe the coagulation dysfunction is. Serious coagulation status should be paid as soon as possible. Premature infants with fibrinogen concentration less than 0.8g / L should lose as soon as possible Note cold precipitation, in improving the prognosis of premature children and improve the survival rate has a positive clinical significance.