不同年龄临产孕妇的凝血功能差异对比及其预测出血并发症的效能分析  

Comparison of difference in coagulation function in parturient women of different ages and analysis of efficiency on predicting bleeding complications

作　　者：汪秀珍 祝梦莹 舒艳玲 Wang Xiu-zhen;Zhu Meng-ying;Shu Yan-ling(Department of Laboratory Medicine,Shangrao Guangxin District Maternal and Child Health Hospital,Shangrao 334000,Jiangxi,China;Department of Laboratory Medicine,Hangzhou D.A.Medical Laboratory Center Co.,Ltd.,Hangzhou 310000,China;Department of Laboratory Medicine,Hengfeng Center for Disease Control and Prevention,Hengfeng 334300,Jiangxi,China)

机构地区：[1]上饶市广信区妇幼保健院检验科,江西上饶334000 [2]杭州迪安医学检验中心有限公司检验科,浙江杭州310000 [3]横峰疾病预防控制中心检验科,江西横峰334300

出　　处：《四川生理科学杂志》2024年第9期2063-2066,共4页

摘　　要：目的:对比不同年龄临产孕妇的凝血功能差异及分析其预测出血并发症的效能。方法:研究2021年6月-2023年3月收治的110例在我院接受定期孕检及分娩的产妇,按照是否为高龄产妇将上述产妇分为高龄组(n=47)和非高龄组(n=63),比较两组产妇凝血功能差异,比较两组出血并发症发生情况,同时分析产前凝血功能指标对产后出血的预测价值。结果:高龄组产妇凝血酶原时间(Prothrombin time,PT)、部分凝血酶时间(Activated partial thromboplastin time,APTT)、凝血酶时间(Thrombin time,TT)相较于非高龄组更长,D-二聚体相较于非高龄组更高(P<0.05),纤维蛋白原(Fibrinogen,FIB)水平相较于非高龄组更低(P<0.05);在110例产妇中,共有7例产妇发生产后出血,产后出血发生率为6.36%(7/110),高龄组与非高龄组产妇产后出血发生率分别为12.77%(6/47)和1.59%(1/63),高龄组产妇产后出血发生率更高(χ^(2)=5.645,P=0.018<0.05)。在非高龄组产妇中,出血产妇PT、APTT、TT均长于未出血产妇,D-二聚体水平均高于未出血产妇,FIB水平均低于未出血产妇,差异有统计意义(P<0.05);在高龄组产妇中,出血产妇PT、APTT、TT均长于未出血产妇,D-二聚体水平均高于未出血产妇,FIB水平均低于未出血产妇,差异有统计意义(P<0.05)。TT、FIB、D-二聚体联合预测产后出血敏感度、特异性分别为100.00%、45.63%,相较于单独预测价值更高(P<0.05)。结论:高龄临产孕产妇PT、APTT、TT、D-二聚体异常增高,FIB降低,且与产后出血密切相关;分娩前TT、FIB、D-二聚体联合检测可有效预测产后出血的发生,有利于临床提前采取针对性预防措施,提升分娩安全性.Objective:To compare the difference in coagulation function in parturient women of different ages and analyze its efficiency on predicting bleeding complications.Methods:Totally 110 parturients who received regular pregnancy examination and delivery in the hospital were studied from June 2021 to March 2023.According to whether they were elderly parturients,the above parturients were divided into elderly group(n=47)and non-elderly group(n=63).The difference in coagulation function and occurrence of bleeding complications were compared between both groups,and the predictive value of prenatal coagulation function indicators on postpartum bleeding was analyzed.Results:The prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)in elderly group were longer than those in non-elderly group,and the D-dimer was higher than that in non-elderly group(P<0.05)while the level of fibrinogen(FIB)was lower than that in non-elderly group(P<0.05).Among the 110 parturients,there were 7 cases of postpartum bleeding,with the incidence of postpartum bleeding of 6.36%(7/110).The incidence rates of postpartum bleeding in elderly group and non-elderly group were 12.77%(6/47)and 1.59%(1/63).The incidence of postpartum bleeding in elderly group was higher(χ^(2)=5.645,P=0.018<0.05).Among parturients in non-elderly group,the PT,APTT and TT in bleeding parturients were longer than those in non-bleeding parturients,and the D-dimer level was higher while the FIB level was lower than that in non-bleeding parturients(P<0.05).Among parturients in elderly group,the PT,APTT and TT in bleeding parturients were longer,and the D-dimer level was higher while the FIB level was lower compared to non-bleeding parturients(P<0.05).The sensitivity and specificity of combination of TT,FIB and D-dimer in predicting postpartum bleeding were 100.00%and 45.63%,which were higher than those of single prediction(P<0.05).Conclusion:The PT,APTT,TT and D-dimer of parturients in elderly group are longer or higher than those in non-elderly gro

关 键 词：不同年龄临产孕妇 凝血功能 产后出血 预测效能 

分 类 号：R446.1[医药卫生—诊断学] R714[医药卫生—临床医学]