危重新生儿凝血功能分析

目的探讨危重新生儿的凝血功能及临床意义。方法依据新生儿危重病例评分法,将60例新生儿分为危重组28例,非危重组32例;入院24h内采血检测血小板(PLT)计数、部分活化凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、纤维蛋白原(FIB)、抗凝血酶Ⅲ(AT-Ⅲ)、蛋白C(PC)、D-二聚体(D-D)。统计分析危重组与非危重组凝血功能指标。结果危重组与非危重组比较,危重组PLT低于非危重组,但两组比较差异无显著性意义(P>0.05),危重组FIB、AT-Ⅲ和PC降低,APTT、PT、TT和D-D升高,两组比较差异有显著性意义(P<0.01～0.05)。结论危重新生儿存在凝血功能紊乱,促凝物质增加,抗凝物质减少,纤溶系统被激活。监测凝血功能各项指标,对危重新生儿的早期干预及治疗有重要意义。

Objective To explore the coagulation function and clinical significance of the critical newborns.Methods According to the neonatal critical illness scoring,60 neonatals were divided into two groups,One group contains 28 cases of critical illness and the other group contains 32 cases of non critical illness.The platelets（PLT） count,part of the activation thromboplastin time（APTT）,prothrombin time（PT）,thrombin time（TT）,fibrinogen（FIB）,antithrombin Ⅲ（AT-Ⅲ）,protein C（PC） and D-dimer（D-D） in the blood were tested within 24 hours after admission,Statistically analyzing the indexes of coagulation function in the two groups.Results Compared to the non-critical group,the PLT of the critical group was lower,and the difference of two groups was not significant（P〈0.05）.FIB、AT-Ⅲ and PC of the critical group decreased,while APTT、PT、TT and D-D of the critical group rised.The difference of the two groups was significant（P〈0.01～0.05）.Conclusion Coagulation function is disordered with coagulant material increaseing,anticoagulation material decreasing,while fibrinolysis system is activated in the critical newborn.It is vitally important to Monitor the indexes of coagulation function in early intervention and treatment of the critical newborn.