凝血指标检测在提高产科弥漫性血管内凝血患者母婴安全率中应用效果研究

Study on the effect of perinatal coagulation index detection in improving maternal and infant safety rate in obstetrics and gynecology

目的 探讨围产期凝血指标检测在提高母婴安全率中的应用效果。方法 回顾性分析2016年2月-2017年8月在本院接受凝血指标检测的孕妇的临床资料,根据其实验室检测结果分为DIC风险组和无DIC风险组。观察2组孕妇血栓弹力图参数、细胞因子的差异,比较2组孕妇妊娠结局、新生儿Apgar评分和结局的差异。结果 DIC风险组孕妇的R、K、α角、MA和CI水平高于无DIC风险组; DIC风险组孕妇的IL-6、hs-CRP、TNF-α水平均高于无DIC风险组; DIC风险组孕妇早产发生率高,正常分娩率为75%; DIC风险组新生儿窒息、新生儿肺炎和高胆红素血症等并发症发生率高于无DIC风险组; DIC风险组新生儿出生时和出生后5 min的Apgar评分均低于无DIC风险组,上述差异均有统计学意义（P 〈0. 05））。结论 DIC风险的孕妇妊娠结局较正常孕妇差,而围产期凝血指标检测能够及早地鉴别有DIC风险的孕妇,对提高母婴安全有积极的意义。

Objective To explore the effect of perinatal coagulation index detection in improving the safety rate of mother and child. Methods The clinical data of pregnant women who underwent coagulation tests in our hospital from February 2016 to August 2017 were retrospectively analyzed. According to their laboratory results, they were divided into DIC risk group and non DIC risk group. The difference of parameters of thrombus map and cytokine in two groups of pregnant women was observed, and the differences of pregnancy outcome, Apgar score and outcome between the two groups of pregnant women were compared. Results The R, K, a, MA, and CI levels of pregnant women in DIC risk group were higher than those without DIC risk group. The levels of IL - 6, hs - CRP and TNF - alpha in pregnant women in DIC risk group were higher than those without DIC. The risk of DIC group had high incidence of preterm delivery, and the normal delivery rate was 75% ; the incidence rates of neonatal asphyxia, neonatal pneumonia and hyperhilirubinemia in the DIC risk group was higher than that in the non - DIC risk group; the Apgar score at birth and 5 min after birth in the DIC risk group was lower than that in the non - DIC risk group. The above differences were statistically significant （P 〈 0, 05 ）. Conclusion The pregnancy outcome of pregnant women with DIC risk is worse than that of normal pregnant women. The detection of coagulation markers in early perinatal period can identify pregnant women with DIC risk and have oositive significance for imoroving maternal and infant safety.