新生儿硬肿症播散性血管内凝血和肺出血的研究及其临床意义

The study and clinical significance in the disseminated intravascular coagulation and pulmonary bleeding of the newborn scleredema

目的 :探讨不同病情硬肿症播散性血管内凝血 (DIC)的出凝血功能改变 ,为合理治疗提供理论依据。方法 :比较观察组 10 0例和对照组 5 0例 5项出凝血指标检测结果。结果 :观察组不同病情之间比较 :凝血酶原时间 ,3P试验 ,血小板计数和外周血红细胞形态无显著性差异 (P均 >0 0 5 ) ;试管法凝血时间比较 ,有显著性差异 (P <0 0 5 )。观察组与对照组 5项指标比较有非常显著性差异 (P <0 0 1)。结论 :新生儿硬肿症存在播散性血管内凝血的出凝血功能改变 ,病情越重改变越明显 ,越易合并DIC、肺出血 ,病死率也越高 ,硬肿症早期血液多呈现高凝状态 ,DIC的晚期多呈现低凝状态。早期肝素治疗 ,不仅可改变血液的出凝血状态 (高凝状态 ) ,而且是防治DIC ,肺出血 ,提高治愈率的有效途径。治疗硬肿症加强综合支持疗法 ,尤其是维持内环境稳定纠正酸中毒切不可忽视 。

Objective: To explore the changes in the function of bleeding and cloting and their interrelationships for the disseminated intravascular coagulation of the newborn scleredema of different types; and to provide theoretical support for the early treatment and the improvement of prognosis. Methods: The five experimental tests were compared in the observed group and the control group. Results: In the observed group, there was no distinctive difference( P >0.05) in the form of the outer blood cells, the counting of blood platelet, the 3P test, and the original time of thrombin. There was distinctive difference in the clotting time adopting test tube method. There were distinctive differences in the compairisons of the five test norms of the observed group and the control group ( P <0.01). Conclusion: There exist changes in the functions of bleeding and clotting in the pathological process of the disease. The more serious the state of illness is,the higher the death rate and the frequency of pulmonary bleeding and low cruor will be, and the lower the frequency of high cruor, and the proportion of the non DIC will be low too. The early hepar in treatment not only changes the state of bleeding and clotting, but is one of the effective ways to prevent and cure DIC and pulmonary bleeding, and improve the rate cure rate.