晚发型维生素K缺乏性出血症的临床分析及预防对策  

Clinical analysis and preventive measures of late-onset vitamin K deficiency bleeding

作　　者：思希尧 李晓龙 李慧荣 张婷 连娇 SI Xiyao;LI Xiaolong;LI Huirong;ZHANG Ting;LIAN Jiao(Yulin Children's Hospital/the People's Hospital of Yuyang District,Yulin 719000,China)

机构地区：[1]榆林市儿童医院/榆阳区人民医院,陕西榆林719000

出　　处：《临床医学研究与实践》2022年第2期1-4,8,共5页Clinical Research and Practice

基　　金：2020年榆林市科协青年人才托举计划项目(No.20200229)。

摘　　要：目的分析晚发型维生素K缺乏性出血症(VKDB)的临床特征,并总结其预防对策。方法将2019年9月至2021年8月本院收治的100例晚发型VKDB患儿设为观察组,选取同期于本院出生的100名健康婴儿为对照组,两组均展开凝血功能指标(PT、APTT、TT、CT)、维生素K缺乏诱导蛋白-Ⅱ(PIVKA-Ⅱ)、维生素K_(1)(VK_(1))、血浆脱-γ-羧基凝血酶原(DCP)、血清抗利尿激素(ADH)及电解质(Na^(+)、Cl^(-)、Mg^(2+)、Ca^(2+))水平检测。比较对照组和观察组的上述指标。依据是否存在昏迷将观察组患儿分为清醒组(n=46)和昏迷组(n=54),比较两组患儿的上述指标。结果观察组的PT、APTT、TT、CT均显著长于对照组,PIVKA-Ⅱ水平显著高于对照组,VK_(1)水平显著低于对照组,差异具有统计学意义(P<0.05)。观察组的DCP、ADH水平显著高于对照组,Na^(+)、Cl^(-)、Mg^(2+)、Ca^(2+)水平显著低于对照组,差异具有统计学意义(P<0.05)。昏迷组的PT、APTT、TT、CT均显著长于清醒组,PIVKA-Ⅱ水平显著高于清醒组,VK_(1)水平显著低于清醒组,差异具有统计学意义(P<0.05)。昏迷组的DCP、ADH水平显著高于清醒组,Na^(+)、Cl^(-)、Mg^(2+)、Ca^(2+)水平显著低于清醒组,差异具有统计学意义(P<0.05)。结论晚发型VKDB存在凝血功能障碍,具体表现为PT、APTT、TT、CT延长,DCP、ADH、PIVKA-Ⅱ水平上升,VK_(1)水平及相关电解质水平降低,通过检测以上指标可为该病的诊断与预防对策制定提供一定参考。Objective To analyze the clinical features of late-onset vitamin K deficiency bleeding(VKDB)and summarize preventive measures.Methods One hundred children with late-onset VKDB treated in our hospital from September 2019 to August 2021 were set as observation group,and 100 healthy infants born in our hospital at the same time were selected as control group.Coagulation function indexes(PT,APTT,TT,CT),vitamin K deficiency inducing protein-Ⅱ(PIVKA-Ⅱ),vitamin K_(1)(VK_(1)),plasma des-γ-carboxy-pothrombin(DCP),serum antidiuretic hormone(ADH)and electrolytes(Na^(+),Cl^(-),Mg^(2+),Ca^(2+))levels of the two groups were detected.The above indexes of the control group and the observation group were compared.According to the existence of coma,the children in the observation group were divided into conscious group(n=46)and comatose group(n=54).The above indexes of the two groups were compared.Results The PT,APTT,TT and CT of the observation group were significantly longer than those of the control group,the level of PIVKA-Ⅱwas significantly higher than that of the control group,the level of VK_(1) was significantly lower than that of the control group,and the differences were statistically significant(P<0.05).The levels of DCP and ADH in the observation group were significantly higher than those in the control group,the levels of Na^(+),Cl^(-),Mg^(2+)and Ca^(2+) were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The PT,APTT,TT and CT in the comatose group were significantly longer than those in the conscious group,PIVKA-Ⅱlevel was significantly higher than that in the conscious group,VK_(1) level was significantly lower than that in the conscious group,and the differences were statistically significant(P<0.05).The levels of DCP and ADH in the comatose group were significantly higher than those in the conscious group,the levels of Na^(+),Cl^(-),Mg^(2+) and Ca^(2+) were significantly lower than those in the conscious group,and the differences were statist

关 键 词：维生素K缺乏性出血 晚发型 凝血功能 维生素K缺乏诱导蛋白 电解质 

分 类 号：R723[医药卫生—儿科]