维生素K水平与新生儿消化道出血相关性及新生儿消化道出血的危险因素分析  

Correlation between vitamin K level and neonatal gastrointestinal bleeding and analysis of risk factors of neonatal gastrointestinal bleeding

作　　者：朱洪斐 魏广友[2] Zhu Hongfei;Wei Guangyou(School of Medicine,Anhui University of Technology,Huainan,Anhui 232004,China;Bozhou People's Hospital,Bozhou,Anhui 236804,China)

机构地区：[1]安徽理工大学医学院,安徽淮南232004 [2]亳州市人民医院,安徽亳州236804

出　　处：《齐齐哈尔医学院学报》2024年第2期129-133,共5页Journal of Qiqihar Medical University

基　　金：国家卫生健康委医药卫生科技发展研究中心课题(WA2020HK60)。

摘　　要：目的探讨维生素K水平与新生儿消化道出血相关性及新生儿消化道出血的危险因素。方法选择2021年5月—2022年10月本院收治的新生儿消化道出血患儿40例以及同期本院住院分娩正常新生儿40名为研究对象。以医院信息系统为依据,调阅入组者相关病例资料,了解其性别、是否为早产儿、是否为极低(超低)体重出生儿、是否确诊重症肺炎、新生儿期是否存在维生素K缺乏、是否合并新生儿肺透明膜病变、是否存在出生窒息史以及分娩方式等,针对入组者出生体重、维生素K水平、出生胎龄以及出生时的Apgar评分等与出血量进行相关性分析,并针对确诊新生儿消化道出血者,使用维生素K治疗,针对影响新生儿消化道出血的相关因素进行单因素及多因素Logistic回归分析,并针对新生儿出血量与出生体重、维生素K水平、出生Apgar评分、胎龄进行相关性分析,比较使用维生素K治疗前后凝血功能指标变化。结果早产儿、极低(超低)体重出生儿、合并重症肺炎、维生素K缺乏以及存在出生窒息史者为影响新生儿消化道出血的相关危险因素,维生素K缺乏、存在新生儿窒息、为极低(超低)体重出生儿以及早产儿为新生儿消化道出血的独立危险因素,新生儿出血量与新生儿出生体重、维生素K水平、出生时Apgar评分以及胎龄等均呈负相关(P<0.05),使用维生素K治疗后,患儿凝血功能指标中的TT、PT和APTT均显著缩短(P<0.05)。结论对于出生存在明确维生素K缺乏、新生儿窒息,且为极低(超低)体重出生儿的早产儿,其发生新生儿消化道出血的可能性较大,且出生体重、维生素K水平、出生时Apgar评分越低的早产儿,其发生新生儿消化道出血可能较大,一旦发生新生儿消化道出血,可使用维生素K1进行治疗具有一定临床价值。Objective To explore the correlation between vitamin K level and neonatal gastrointestinal bleeding and the risk factors of neonatal gastrointestinal bleeding.Methods A total of 40 patients suffering from neonatal gastrointestinal bleeding who were admitted to Bozhou people's hospital from May 2021 to October 2022,as well as 40 normal newborns delivered in our hospital during the same period,were selected as the study subjects.Based on the hospital information system,access to the relevant case data of the participants to understand their gender,whether they were premature,whether they were very low(ultra-low)weight babies,whether they were diagnosed with severe pneumonia,whether there was vitamin K deficiency in the newborn period,whether they were complicated with hyaline membrane disease of the newborn,whether there was a history of birth asphyxia,and the mode of delivery.The correlation analysis was carried out between the birth weight,vitamin K level,gestational age and Apgar score at birth and the amount of bleeding.For those diagnosed with neonatal gastrointestinal bleeding,vitamin K was used for treatment.Single factor and multi-factor logistic regression analysis was carried out for the related factors affecting neonatal gastrointestinal bleeding,and the correlation analysis was carried out between the amount of neonatal bleeding and birth weight,vitamin K level,birth Apgar score,and gestational age.The changes of coagulation function before and after vitamin K treatment were compared.Results Premature,very low(ultra-low)birth weight,complicated with severe pneumonia,vitamin K deficiency and birth asphyxia history were related risk factors for neonatal gastrointestinal bleeding.Vitamin K deficiency,neonatal asphyxia,very low(ultra-low)birth weight and premature were independent risk factors for neonatal gastrointestinal bleeding.Neonatal blood loss was negatively correlated with neonatal birth weight,vitamin K level,Apgar score at birth and gestational age(P<0.05).TT,PT and APTT in coagulation function i

关 键 词：新生儿 消化道出血 维生素K 危险因素 

分 类 号：R722.1[医药卫生—儿科]