败血症治疗时加用小剂量肝素对早产儿凝血指标及治疗效果的观察  

Effect of low dose heparin on coagulation index and therapeutic outcomes in premature infants with sepsis

作　　者：刘巍巍[1] 焦颖[1] 邹丽颖[2] 韩冬韧[1] Liu Weiwei;Jiao Ying;Zou Liying;Han Dongren(Department of Neonatology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China;Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China)

机构地区：[1]首都医科大学附属北京妇产医院新生儿科,100026 [2]首都医科大学附属北京妇产医院产科,100026

出　　处：《中华全科医师杂志》2019年第8期756-759,共4页Chinese Journal of General Practitioners

摘　　要：目的探讨早产儿败血症治疗时加用小剂量肝素对凝血指标的影响.方法回顾性分析北京妇产医院2009年7月至2018年6月收治的早产且出生体重<1500g的败血症患儿共69例,按照是否使用小剂量肝素治疗(每次6U/kg,每6~8小时1次,连用3d,后改为每12小时1次,疗程5d)分为治疗组和对照组,评价两组治疗对早产儿凝血指标的影响及临床治疗效果.结果治疗组治疗后凝血功能显示凝血酶原时间(PT)、凝血酶凝结时间(TT)、活化凝血酶原时间(APTT)及D-二聚体水平分别为(15.5±3.5)s、(15.4±3.5)s、(47.5±8.6)s、(1.7±0.8)mg/L,对照组分别为(19.0±3.9)s、(18.8±3.5)s、(58.4±18.1)s、(2.6±1.9)mg/L,治疗组较对照组凝血功能明显改善(t值分别为-3.815、4.275、-3.004、-2.459,均P<0.05).治疗组临床总有效率(86.2%,25/29)高于对照组(60.0%,24/40),差异有统计学意义(x2=4.408,P<0.05).结论早产儿发生败血症时,加用小剂量肝素治疗可以显著改善凝血功能,提高早产儿败血症的治疗效果.Objective To investigate the effect of low dose heparin on blood coagulation and therapeutic outcomes in premature infants with sepsis.Methods Clinical data of 69 septic preterm newborns weighting less than 1 500 g treated in Beijing Obstetrics and Gynecology Hospital were retrospectively analyzed.Among them,29 infants received heparin therapy (6 U/kg,q 8 h,for 3 d,then q12 h,heparin group)and 40 infants did not receive heparin therapy (control group),the coagulation index and therapeutic outcomes were compared between two groups.Results The coagulation indexes PT,TT,APTT and D dimer in heparin group were all significantly lower than those in control group [(15.5±3.5) s vs.(19.0±3.9) s,(15.4±3.5) s vs.(18.8±3.5) s,(47.5±8.6) s vs.(58.4±18.1) s,(1.7±0.8) mg/L vs.(2.6±1.9) mg/L;t=-3.815,4.275,-3.004,-2.459,P<0.05].The overall clinical effective rate in heparin group was significantly higher than that in control group (86.2% vs.60.0%,x2 =4.408,P<0.05).Conclusion Low dose heparin can significantly improve the blood coagulation function and improve the therapeutic effect of premature infants with sepsis.

关 键 词：肝素 败血症 早产儿 极低出生体重儿 

分 类 号：R722.6[医药卫生—儿科]