胎盘早剥新生儿的临床特征及普通肝素的干预作用  

Clinical characteristics of neonates with placental abruption and the effect of unfractionated heparin

作　　者：常迎香[1] 李秀琴[1] 闫爱新[1] 孙菊英[1] Chang Yingxiang;Li Xiuqin;Yan Aixin;Sun Juying(The Fourth People＇s Hospital of Hengshui,Hengshui 053000,China)

机构地区：[1]河北省衡水市第四人民医院产二科,衡水053000

出　　处：《广西医科大学学报》2018年第9期1202-1206,共5页Journal of Guangxi Medical University

基　　金：河北省衡水市科技计划课题资助项目(No.2016014059Z)

摘　　要：目的:探讨胎盘早剥新生儿的临床特征,并分析普通肝素对此类新生儿的干预作用。方法:选取2017年4—12月于河北省衡水市第四人民医院娩出的189例胎盘早剥新生儿为观察组,采用信封随机法将其分为3个亚组:A组、B组和C组,分别采用0.1mg/kg、0.2mg/kg、0.3mg/kg普通肝素干预。以非胎盘早剥新生儿63例作为对照组。比较各组新生儿临床特征、并发症情况及凝血功能指标。结果:观察组贫血、酸中毒、电解质紊乱、缺氧性心肌损害、窒息发生率明显低于对照组(P<0.05)。入院时,观察组活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)明显长于对照组,纤维蛋白原(FIB)明显低于对照组,D-二聚体(D-D)明显高于对照组,差异有统计学意义(P<0.05)。治疗后,A组APTT明显长于C组,FIB明显高于C组,D-D明显低于B组,差异有统计学意义(P<0.05)。观察组3个亚组治疗期间并发症发生率及治愈率比较,差异无统计学意义(P>0.05)。结论:胎盘早剥新生儿发生贫血、酸中毒、电解质紊乱、缺氧性心肌损害、窒息等并发症风险较高,且多存在凝血功能障碍。早期应用0.1~0.3mg/kg肝素干预有助于纠正凝血功能异常,且选择0.1mg/kg剂量更为合理。Objective： To investigate the clinical characteristics of neonates with placental abruption,and to analyze the effect of unfractionated heparin application in these neonates.Methods： A total of 189 neonates with placental abruption born in our hospital from April 2017 to December 2017 were enrolled as an observation group,and they were randomly divided into A,B and C sub-groups （respectively treated with 0.1 mg/kg, 0.2 mg/kg and 0.3 mg/kg heparin）.63 neonates without placental abruption were defined as a control group.The clinical features,complications and coagulation function were observed and compared.Results： The incidences of anemia,acidosis,electrolyte disorder,hypoxic myocardial damage and asphyxia in the observation group were significantly lower than those in the control group （ P 〈0.05）.At admission,the activated partial thromboplastin time （APTT） and prothrombin time （PT） in the observation group were significantly longer than those in the control group,the fibrinogen （FIB） level was lower,and the D-dimer （D-D） level was higher （ P 〈0.05）.There were no significant differences among A,B and C groups in the incidence of complications and response rate （ P 〉0.05）.Conclusion： Neonates with placental abruption had high risks of anemia,acidosis,electrolyte disturbance,anoxic myocardial damage,asphyxia and other complications,and exhibited coagulation dysfunction.Early application of 0.1 to 0.3 mg/kg heparin could help to correct abnormal coagulation function,and 0.1 mg/kg was more reasonable.

关 键 词：新生儿 胎盘早剥 凝血功能 肝素 

分 类 号：R711.2[医药卫生—妇产科学]