出生后低体重消化道畸形患儿围手术期血小板监测的临床意义

A contrast study of monitoring change of platelet in postoperative low birth weight infants

目的通过对10年来低体重消化道畸形儿血小板的检测及对比研究，为临床上低体重儿的治疗监测提供一种指标。方法将2002年1月至2011年12月上海交通大学医学院附属新华医院小儿外科手术治疗的早产儿、低体重儿共128例作为检测对象，分为败血症组和非败血症组，选取同期治疗的成熟儿125例作为对照组，测定各组血小板计数和平均血小板体积（MPV）。结果败血症组术后血小板计数为（98±76）×109/L，血小板平均体积为（12.4±1.95）fL，非败血症组术后血小板计数为（179±73）×109/L，血小板平均体积为（10.7±1.87）fL，败血症组血小板计数较术前明显下降（P〈0.05），术后血小板计数较非败血症组术后下降明显（P〈0.05），败血症组术后血小板平均体积较术前明显升高（P〈0.05），术后血小板平均体积较无败血症组术后明显升高（P 〈 0.05），无败血症组术后血小板计数和血小板平均体积与对照组无显著差异。结论血小板计数和血小板平均体积可以作为新生儿和低体重儿危重症评价的指标之一。

Objective Sepsis is commonly observed in postoperative low birth weight infants, The purpose of this study was to examine platelet counts and mean platelet volume （MPV） in postoperative LBW infants to determine which can be used to screen for sepsis in neonates who are clinically suspected of infection. Methods The study cohort consisted of 128 infants during decade, They were divided into sepsis group and non-sepsis group. They were investigated MPV and platelet count during preoprative and postoperative, 125 fullterm infants investigated at meantime as control. Results The postoperative PLT in sepsis group was （ 108 ±68 ） ×109/L, the postoperative MPV in sepsis group was（ 12.4 ±1.95 ）fL,The postoperative PLT in non- sepsis group was （ 179 ±73 ）×109/L, the postoperative MPV in non-sepsis group was （ 10.7 ±1.87 ） fL. Within postoperative sepsis group of increasing severity,lower PLT （P 〈 0. 05） and higher MPV （P 〈0.05） were identified. Conclusion The platelet count and MPV are sepsis predictive markers in postoperative low~ birth weight infants.