晚发型维生素K缺乏性出血中文文献报告病例20年(1989—2008)综合分析

Analysis of cases of late vitamin K deficiency bleeding in infancy reported in the Chinese literatures for last two decades (1989—2008).

【目的】综合分析中文期刊晚发型维生素K缺乏性出血病例报告资料,了解我国晚发型维生素K缺乏性出血的病例特征、发病趋势、地区分布和高危因素等。【方法】＂维生素K缺乏＂为主题词,1989年1月—2008年8月为检索时段,检索中文期刊全文数据库、维普、万方、中国生物医学文献数据库上涉及维生素K缺乏的全部文献,逐篇甄别,遴选出＂晚发型维生素K缺乏性出血＂的病例报告一次文献,建立excel数据库。【结果】晚发型维生素K缺乏性出血文献1 448篇,其中792篇文献不适合做病例分析,剔除,656篇文献用于分析。656篇文献所涉及的晚发型维生素K缺乏性出血病例数21 894例,遍及30个省市自治区。母乳喂养占90.1%;男女之比为2.22∶1;4周以内发病占6%,4~8周占73%,8周以上占21%。高危因素包括：乳母用药、肝胆疾患、呼吸道感染、腹泻、应用抗生素、发热等。出血部位以颅内出血为主,高达90.4%。后遗症发生率为20%,以运动障碍或智力障碍多见。【结论】我国晚发型维生素K缺乏性出血发病形势严峻;母乳喂养儿多见,男童易患,4-8周为高发年龄。颅内出血发生率极高。高危因素为乳母用药,小儿使用抗生素、患腹泻、呼吸道感染等、肝胆疾病等。

【Objective】 To explore the characteristics,the incidence trend,distribution areas and high risk factors of late VKDB in China. 【Methods】 ＂Vitamin K deficiency＂ was selected as the keyword for retrieval in literatures of late VKDB published in Chinese journals.The databases for searching included China National Knowledge Infrastructure（CNKI）,VIP database,Wanfang database and Chinese BioMedical Literature Database（CBM）.Time limitation for retrieval was form Jan.1989 to Aug.2008.Various items of data were extracted from selected literatures and imported to Excel for analysis. 【Results】 1 448 pieces of Chinese articles about late VKDB were obtained.792 pieces were excluded.656 articles about case report were adopted.The total case number of late VKDB reported in the 656 articles was 21 894.These cases of late VKDB spread all over thirty administrative areas.The breast feeding accounted for 90.1%.The male/female ratio was 2.22∶1.The disorder accounted for 6% within 4 weeks,for 73% between 4~8 weeks,for 21% over 8 weeks.Potential high risk factors of late VKDB included in medication for lactating mothers,hepatobiliary diseases,respiratory infection,diarrhea,application of antibiotics and fever.The incidence of intracranial hemorrhage was up to 90.4%.The sequelae were 20%. 【Conclusions】 In China,the incidence of late VKDB is severe.Breast-feeding infants happen more.The boys are liability.The peak age is from 4 to 8 weeks.The risk factors include in antibiotic treatment,infections（diarrhea,respiratory tract infection et al）,liver or gallbladder diseases and so on.