监测D-二聚体及小剂量肝素早期治疗小儿危重症的临床意义

Mnitor D-Dimmer and Little Dose of Heparin Treament for Children′s Critical Illness

目的：监测D-二聚体,进行危重症评分,评价监测D-二聚体对危重症预后的价值;评价小剂量肝素对小儿危重症的疗效。方法：将2008-01~2009-12收入我院PICU诊断危重症病人72例,随机分成肝素治疗组和对照组各36例,监测两组病人D-二聚体,凝血酶原时间,部分凝血活酶时间,纤维蛋白降解产物并进行危重症评分。结果：小儿危重症病人治疗后D-二聚体降低,肝素治疗组和对照组比较差异有统计学意义（P〈0.01）。两组小儿治疗前及治疗5 d进行危重症评分均有所升高,治疗组较对照组明显。差异有统计学意义（P〈0.05）。结论：D-二聚体在各种危重症疾病均有升高,低分子小剂量肝素治疗对改善危重症小儿病情有效,对凝血功能尤其是D-D改善明显。

Objective：To monitor D - Dimmer, To evaluate the efficacy of little dose of heparin treament in children with critical illness. Methods ： A total of 72 patients with critical illness randomly divided into little dose of heparin trentment group and control group. Both group were monitored D - D and other funtion of hemorrhagic - coagulation（ include PLT,PT, APTI＇, FDP）and severity score. Results： D - Dimmer in these two groups were dicline after threatment, there was a significant difference between these two groups （ P 〈 0.01 ）. In these two groups, The other funtion of coagulation have some changes after treatment but there was no statistic difference between these two groups （ P 〉 0. 05 ）, Severity score in these two groups was increased after 5day＇s treatment;Severity score in little dose of heparin treatment group was increased more significantly than that of control ;There was a significant difference between these two groups （P 〈 0. 05 ）. Conclusions ： D - D concentration will increase in a lot of critical illness, little dose of heprin treatment in children with critical disease is effective on improving serious condition and on funtion of coagulation, especially on D - D concentration.