回顾分析脓毒症患儿凝血功能紊乱的干预措施

Retrospective analysis of the interventions in sepsis children with coagulation disorders

目的探究分析降低严重脓毒症患儿凝血功能紊乱发生率的途径。方法随机抽取在贵港市人民医院儿科接受治疗的患有严重脓毒症患儿50例,将其随机分成实验组和对照组,每组25人,分别测得D-二聚水平。实验组给予小剂量肝素钙,每次给药11~211U/kg,每5小时皮下注射1次,连续5天持续用药;对照组只给予少剂量抗毒素血清类药物进行治疗。观察两组患儿的凝血功能,并加以分析。结果对照组的D-二聚水平(851.3±130.7)明显高于实验组的D-二聚水平(653.5±120.1),差异有统计学意义(t=5.5718,P<0.05);对照组的死亡率(60.00%)明显高于实验组的死亡率(24.00%),差异有统计学意义(x^2=6.6502,P<0.05)。对照组凝血率、原发病恢复率明显低于实验组,差异均有统计学意义(x^2值分别为3.9452、5.0125,均P<0.05);对照组出现凝血障碍率明显高于实验组,差异也有统计学意义(x^2=4.3796,P<0.05)。结论对严重脓毒症患儿使用肝素钙降低了婴幼儿的死亡率,并明显改善了脓毒症患儿的凝血功能,可在临床上推广使用。

Objective To explore and analyze the way to reduce the incidence of coagulation disorders among severe sepsis children . Methods Fifty children with severe sepsis visiting People ’ s Hospital in Guigang City were randomly selected and divided into experimental group and control group with 25 cases in each group .D-dimer level of 50 cases were measured before the trial .The experimental group was given a small dose of heparin, 11-21IU/kg.It was given by subcutaneous injection every five hours in 5 consecutive days.The control group was only given small doses of antitoxin drugs for treatment .The coagulation of two groups was observed and analyzed .Results The D-dimer level of the control group （851.3 ±130.7） was significantly higher than the experimental group （653.5 ±120.1）, and there was significant difference （t=5.5718,P〈0.05）.The mortality of the control group （60.00%） was significantly higher than the experimental group （24.00%）, and the difference was significant （χ2 =6.6502,P〈0.05）.The coagulation rate and recovery rat of the control group were remarkably lower than those of the experimental group , and the differences were significant （χ2 value was 3.9452 and 5.0125, respectively, both P〈0.05）.The incidence of coagulation disorders was significantly higher in the control group than in the experimental group （χ2 =4.3796, P〈0.05）.Conclusion Heparin calcium can reduce the mortality and significantly improve the coagulation function of infants and young children with serious sepsis .It can be promoted in clinics .