638例孕妇及其新生儿维生素K1应用情况调查分析

Investigation and analysis on usage of vitamin K1 in 638 cases of pregnant women and their neonates

目的分析638例孕妇及其新生儿维生素K1的应用情况。方法向山东地区各级医院产科及新生儿科医生发布维生素K1应用情况调查问卷,收集638例孕妇及其新生儿维生素K1应用临床资料,分析其应用情况。结果638例孕妇中,540例(84.63%)产前不常规补充维生素K1、559例(87.58%)产后不常规补充。健康新生儿生后均予补充维生素K1,途径均为肌肉注射;应用时不考虑其胎龄/体质量198例,因"胎龄/体质量不同"应用剂量不同79例;因产程延长、胎盘早剥等不确定原因临时决定应用剂量14例;应用1次263例,2次9例,3次及以上18例;生后即刻应用190例,生后24 h内99例,生后24 h后13例。患病新生儿肌肉注射维生素K1226例、静脉点滴67例、静脉推注50例、口服4例;应用时不考虑其胎龄/体质量149例,因"胎龄/体质量不同"应用剂量不同171例,依据入院时情况如凝血异常、重症感染等临时决定维生素K1应用剂量27例;入院后常规应用维生素K1注射液289例,被考虑是否曾用过、有无出血倾向、腹泻、长期应用抗生素、母乳喂养、距离上次应用是否超过1周等因素58例;入院3 d内应用272例,入院3 d之内及以后应用74例,入院3 d后应用1例。所有新生儿中,出院后不常规补充501例,表示不了解111例,常规补充26例。结论638例孕妇产前及产后维生素K1补充不足;健康新生儿和患病新生儿维生素K1应用剂量不一,健康新生儿出院后维生素K1补充不足,患病新生儿住院期间维生素K1补充剂量过大、出院后补充不足。

Objective To analyze the use of vitamin K1 in 638 pregnant women and their newborns.Methods A questionnaire was distributed to obstetricians and neonatologists in hospitals of all levels in Shandong province.The clinical data of 638 pregnant women and their newborns with vitamin K1 medication were collected and analyzed.Results Among the 638 pregnant women,540 cases(84.63%)did not regularly take vitamin K1 before delivery and 559 cases(87.58%)did not regularly take vitamin K1 after delivery.All healthy neonates were given vitamin K1 by intramuscular injection.The gestational age/body weight was not considered in 198 cases,and the dosage was different in 79 cases due to"different gestational age/body weight".The dosage was temporarily decided in 14 cases due to uncertain reasons such as prolonged labor or placental abruption.A total of 263 cases were given once,9 cases were given twice,and 18 cases were given three times or more;190 cases were given immediately after birth,99 cases within 24 h and 13 cases after 24 h.Among all diseased neonates,there are 226 cases of intramuscular injection of vitamin K1,67 cases of intravenous drip,50 cases of intravenous injection and 4 cases of oral administration;in 149 cases,we did not consider the gestational age/body weight,171 cases were given different doses due to"different gestational age/body weight",and in 27 cases,we temporarily decided the dosage of vitamin K1 according to the conditions at admission,such as abnormal coagulation,severe infection,etc.After admission,289 cases were routinely treated with vitamin K1 injection,and 58 cases were depended on whether they had been used before,whether they had bleeding,diarrhea,long-term use of antibiotics,breastfeeding,and the time of more than 1 week since the last application,etc;272 cases were used within 3 days of admission,74 cases were used within 3 days of admission and thereafter,and 1 case was used after 3 days.Among all newborns,501 cases were not routinely supplemented after discharge,111 cases were unaware of that,and 26 cases were routinely supplemented after discharge.Conclusions A total of 638 pregnant women were deficient in vitamin K1 supplementation prenatally and postnatally.The dosage of vitamin K1 used in healthy children and sick children is different,the healthy children have insufficient vitamin K1 supplement after discharge,and the sick newborn have excessive vitamin K1 supplement during hospitalization but insufficient vitamin K1 supplement after discharge.