晚发性维生素K缺乏性颅内出血56例临床分析

Late intracranial hemorrhage by vitamin K deficiency: an analysis of 56 cases

目的 探讨婴儿期维生素K缺乏的病因及预防措施。方法 对本院收治56例晚发性维生素K缺乏性出血进行回顾性分析。纯母乳喂养45例,有腹泻病史18例,抗生素用药史16例,有肝病史2例为主要病因。发病年龄25d～2月52例,2～3月4例,经静注或肌注维生素K1及降颅内高压、抗惊厥、纠正贫血等对症处理。其中7例硬脑膜下出血者给予硬脑膜下穿刺放血治疗。结果 治愈49例(49/56),死亡2例(2/56),放弃5例(5/56),存活病例有神经系统后遗症34例(34/49)。结论 对纯母乳喂养、腹泻、使用抗生素及有肝病的患儿,在常规预防的同时应注意强化预防措施。

Objective To study the etiological factors and preventive measures of intracranial hemorrhage associated with vitamin K deficiency. Methods A retrospective study was carried out as to the clinical features and outcome of intracranial haemorrhages by late vitamin K deficiency in 56 infants who were admitted to our hospital during a 4-year period (June 1998-June 2003). The risk factors for intracranial hemorrhage associated with vitamin K deficiency included exclusively breast-fed infants (45/56), diarrhea (18/56), history of antibiotics (16/56) and liver disease (2/56). All patients were treated by giving vitamin K, lowering encephalic high pressure, repelling convulsion, transfusing fresh blood and phlebotomy. Results 49 cases (49/56) were healed, 2 (2/56) dead, 5 (5/56) abandoned, 34 (34/49) with nervous system sequelaes. Conclusion For infant patients with exclusively breast-fed, diarrhea, history of antibiotic and liver disease, it is of great importance to enhance preventive measures besides routine preventive measures.