窒息新生儿凝血功能状态检测及临床意义  

Detection and clinical significance of coagulant function of neonates with asphyxia

作　　者：赵捷[1] 庄思齐[2] 

机构地区：[1]广东省深圳市妇幼保健院新生儿科,518020 [2]中山大学第一附属医院

出　　处：《中国妇幼保健》2011年第18期2765-2766,共2页Maternal and Child Health Care of China

摘　　要：目的:探讨窒息新生儿凝血相关指标的改变及临床意义,为临床早期干预异常的凝血象提供依据。方法:将276例新生儿分为4组,即正常足月儿(70例)、窒息足月儿(65例)、无窒息早产儿(77例)、窒息早产儿(62例)。在出生后24h内分别检测凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原(Fg)、凝血酶时间(TT)和D-二聚体等5项指标。结果:窒息足月儿与正常足月儿PT、APTT、Fg、TT比较差异无统计学意义,但窒息足月儿D-二聚体升高,两组比较差异有统计学意义(P<0.01)。与无窒息早产儿比较,除TT外,窒息早产儿PT、APTT均延长,D-二聚体升高,Fg降低(P<0.05);与窒息足月儿比较,窒息早产儿PT、APTT、TT均延长,D-二聚体升高,Fg降低(P<0.01)。结论:窒息足月儿大都存在以高凝为特征的前DIC或DIC早期,窒息早产儿更容易发生DIC。Objective：To explore the change of coagulation related indexes and its clinical significance in neonates with asphyxia,provide a basis for clinical early intervention of abnormal blood coagulation.Methods：276 neonates were divided into 4 groups：normal full term infants（70 neonates）,asphyxial full term infants（65 neonates）,non-asphyxial premature infants（77 neonates） and asphyxial premature infants（62 neonates）.Five indexes including prothrombin time（PT）,activated partial prothrombin time（APTT）,fibrinogen（Fg）,thrombin time（TT） and D-dimer were detected respectively at 24 hours after birth.Results：There was no significant difference in PT,ATPP,Fg and TT between asphyxial full term infants and normal full term infants,but D-dimer content in asphyxial full term infants increased,there was significant difference between the two groups（P0.01）.Compared with non-asphyxial premature infants,PT and APTT in asphyxial premature infants prolonged except TT,D-dimer content increased,Fg decreased（P0.05）.Compared with asphyxial full term infants,PT,APTT and TT in asphyxial premature infants prolonged,D-dimer content increased,Fg decreased（P0.01）.Conclusion：Pre-DIC and early DIC characterized by hypercoagulation exist in most of the asphyxial full term infants,DIC is easily to occur in asphyxial premature infants.

关 键 词：窒息 新生儿 凝血 弥散性血管内凝血 

分 类 号：R722.12[医药卫生—儿科]