1057例新生儿出生初期部分凝血功能检测指标危急值分析

Analysis of the critical values of partial coagulation function indicators in 1 057 neonates in the early stages of life

目的 探讨不同胎龄新生儿出生初期凝血功能检测四项指标的危急值参考范围。方法 选取2012年1月1日—2021年12月31日在深圳市3家三级甲等医院住院的新生儿1 110例,按胎龄分为早期早产儿、中期早产儿、晚期早产儿和足月儿,患儿入院24 h内检测凝血功能四项指标。建立新生儿出生初期凝血功能四项指标的危急值参考范围,并依据此范围判断中山大学附属第八医院1 588例新生儿的病情。结果 凝血功能危急值参考范围,早期早产儿:活化部分凝血活酶时间(APTT)≥96.6 s或≤46.7 s、凝血酶原时间(PT)≥21.4 s或≤12.5 s、凝血酶时间(TT)≥23.9 s或≤15.7 s、FIB≥3.1 g/L或≤0.9 g/L;中期早产儿:APTT≥92.4 s或≤49.1 s、PT≥18.9 s或≤12.3 s、TT≥23.5 s或≤15.4 s、FIB≥3.0 g/L或≤1.1 g/L;晚期早产儿:APTT≥93.4 s或≤54.8 s、PT≥17.1 s或≤12.5 s、TT≥19.3 s或≤15.3 s、FIB≥2.2 g/L或≤1.1 g/L;足月儿:APTT≥77.6 s或≤42.0 s、PT≥17.4 s或≤12.2 s、TT≥19.0 s或≤14.5 s、FIB≥2.4 g/L或≤1.3 g/L。1 588例新生儿中,早期早产儿危急值检出率为12.61%(14/111),以呼吸窘迫综合征为主;中期早产儿危急值检出率为10.99%(21/191),以呼吸窘迫综合征、出血性疾病为主;晚期早产儿危急值检出率为5.33%(25/469),以高胆红素血症、出血性疾病、窒息为主;足月儿危急值检出率为4.28%(35/817),以出血性疾病、窒息为主。结论 建立不同胎龄新生儿出生初期凝血功能四项指标的危急值参考范围,对重症新生儿病情预测具有重要的参考价值。

Objective To investigate the critical values of four coagulation indexes in neonates of different gestational ages at the beginning of life.Methods A total of 1 110 eligible newborns hospitalized in 3 level-A tertiary hospitals in Shenzhen from January 1,2012 to December 31,2021 were selected.Based on the gestational age,they were divided into early preterm infants,middle preterm infants,late preterm infants and term infants,and four indicators of coagulation function were detected within 24 hours after admission.To establish the reference ranges of four critical values of neonatal coagulation function in the early stage of life,and to determine the condition of 1 588 neonates admitted to the Eighth Affiliated Hospital of Sun Yat-sen University during the same period.Results The critical values of coagulation function in early preterm infants were APTT ≥96.6 s or ≤46.7 s,PT ≥21.4 s or ≤12.5 s,TT ≥23.9 s or ≤15.7 s,FIB ≥3.1 g/L or ≤0.9 g/L;In medium preterm infants were APTT ≥92.4 s or ≤49.1 s,PT ≥18.9 s or ≤12.3 s,TT ≥23.5 s or ≤15.4 s,FIB ≥3.0 g/L or ≤1.1 g/L;In Late premature infants were APTT ≥93.4 s or ≤54.8 s,PT ≥17.1 s or ≤12.5 s,TT ≥19.3 s or ≤15.3 s,FIB ≥2.2 g/L or ≤1.1 g/L;In full-term infants were APTT ≥77.6 s or ≤42.0 s,PT ≥17.4 s or ≤12.2 s,TT ≥19 s or ≤14.5 s,FIB ≥2.4 g/L or ≤1.3 g/L.Among the 1 588 neonates,the detection rate of critical values in early preterm infants was 12.61%(14/111),mainly respiratory distress syndrome;the detection rate of critical values in mid-term preterm infants was 10.99%(21/191),mainly respiratory distress syndrome and neonatal hemorrhagic diseases.The detection rate of critical values in late preterm infants was 5.33%(25/469),mainly neonatal hyperbilirubinemia,neonatal hemorrhagic diseases and neonatal asphyxia.The detection rate of critical values in full-term infants was 4.28%(35/817),mainly neonatal hemorrhagic diseases and neonatal asphyxia.Conclusion The reference ranges of four critical values of coagulation function in neonates with different gestational ages at the early stage of life have been established,which has an important reference value for predicting the condition of severe neonates.