低分子肝素抗凝治疗对肺出血新生儿凝血功能指标的影响

Effect of Low Molecular Weight Heparin anticoagulation therapy on coagulation function index in neonates with pulmonary hemorrhage

目的探讨低分子肝素抗凝治疗对肺出血新生儿凝血功能指标的影响。方法选择2016年1月～2018年5月于我院新生儿重症监护治疗病房(NICU)住院的肺出血患儿40例,所有患儿的血小板水平<80×109/L,按照随机数字表法将患儿分为观察组与对照组,对照组20例患儿给予常规的重症监护治疗病房(ICU)急救护理措施以及普通肝素。观察组20例患儿在对照组基础上给予低分子肝素。比较两组患儿弥散性血管内凝血(DIC)发生率、临床疗效以及凝血功能指标在治疗前后的变化。结果观察组患儿的治疗总有效率(75.00%)明显高于对照组(45.00%),差异有统计学意义(P<0.05)。观察组患儿的DIC发生率(30.00%)明显低于对照组(60.00%),差异有统计学意义(P<0.05)。治疗前两组患儿的活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血致活酶期(TT)比较,差异无统计学意义(P>0.05);治疗后两组患儿的APTT、PT、TT均明显短于治疗前,差异有统计学意义(P<0.05);治疗后观察组患儿的APTT、PT、TT均明显短于对照组,差异有统计学意义(P<0.05)。治疗前两组患儿的纤维蛋白(原)降解产物(FDP)与D-二聚体(D-D)水平比较,差异无统计学意义(P>0.05);治疗后两组患儿的FDP与D-D水平均明显低于治疗前,差异有统计学意义(P<0.05);治疗后观察组患儿的FDP与D-D水平均明显低于对照组,差异有统计学意义(P<0.05)。结论采用低分子肝素治疗新生儿肺出血,可显著改善凝血功能指标水平,疗效可靠,值得临床推广应用。

Objective To explore the effect of Low Molecular Weight Heparin anticoagulation therapy on coagulationfunction index in neonates with pulmonary hemorrhage. Methods A total of 40 children with pulmonary hemorrhagehospitalized in neonatal intensive care unit （NICU）of our hospital from January 2016 to May 2018 were selected. Thelevel of platelets in all children was lower than that of 80伊109/L, the children were divided into the observation groupand the control group according to the random number table method, and 20 cases of the control group were given theroutine intensive care unit （ICU） emergency nursing measures and the ordinary heparin. A total of 20 children in theobservation group were given Low Molecular Weight Heparin on the basis of the control group. The incidence of DIC,the clinical effict and the changes of coagulation function index before and after treatment in the two groups were compared. Results The total effective rate of the observation group （75.00%） was significantly higher than that of the control group （45.00%）, and the difference was statistically significant （P〈0.05）. The incidence of DIC in the observationgroup （30.00%） was significantly lower than that in the control group （60.00%）, and the difference was statistically significant （P〈0.05）. There were no significant differences in the active partial thromboplastin time （APTT）, prothrombintime （PT） and thromboplastin time （TT） between the two groups before treatment （P〉0.05）; After treatment, the APT, PTand TT in the two groups of the children were significantly shorter than those before treatment, the differences were statistically significant （P〈0.05）; and the APTT, PT, TTof the children in the observation group were significantly shorter than those in the control group after treatment,and the differences were statistically significant（P〈0.05）. There were no significant differences in the levels of fibrin （-ogen） degradation products （FDP） and D-dime （D-D） between the two groups of the children before treatment （P〉0.05）.The levels of FDP and D-D in the in the two groups of the children were significantly lower than those before the treatment, the differences were statistically significant （P〈0.05）. The levels of FDP and D-D of the children in the observation group after treatment were lower than those of the control group, the differences were statistically significant（P〈0.05）. Conclusion Using Low Nolecular Weight Heparin to treat pulmonary hemorrhage in neonates can significantlyimprove the level of coagulation function index, the curative effect is reliable, and it is worthy of clinical application.