蛇毒血凝酶联合维生素K 1治疗新生儿消化道出血的临床效果  

Clinical efficacy of hemocoagulase combined with VK 1 in the treatment of neonatal gastrointestinal bleeding

作　　者：陈婉蓉 郑芳 魏恩焕 CHEN Wanrong;ZHENG Fang;WEI Enhuan(Department of Pediatrics,Sanming First Hospital Affiliated to Fujian Medical University,Fujian Province,Sanming 365000,China)

机构地区：[1]福建医科大学附属三明第一医院儿科,福建省三明市365000

出　　处：《临床合理用药杂志》2024年第35期36-38,41,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：福建省自然科学基金计划项目(2023J1123736)。

摘　　要：目的观察蛇毒血凝酶联合维生素K 1治疗新生儿消化道出血的临床效果。方法回顾性分析2022年3月—2024年3月福建医科大学附属三明第一医院收治的75例新生儿消化道出血患儿临床诊疗资料,以治疗方案不同分为观察组(38例)和对照组(37例)。在常规治疗基础上,对照组单纯予维生素K 1注射液治疗,观察组在对照组基础上加用蛇毒血凝酶注射液治疗,2组均治疗3 d。比较2组治疗效果,呕血、血便、腹胀等症状改善及粪便隐血试验转阴时间,治疗前1 d、治疗后3 d凝血功能指标[纤溶酶原激活物抑制剂-1(PAI-1)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、D-二聚体(D-D)、组织型纤溶酶原激活物(t-PA)]水平及不良反应。结果观察组患者治疗总有效率为97.37%,高于对照组的83.78%(χ2=4.088,P=0.043);观察组呕血、血便、腹胀等症状改善及粪便隐血试验转阴时间均短于对照组(P<0.01)。治疗后3 d,2组TT、APTT、t-PA较治疗前缩短或降低,其余指标升高(PAI-1对照组内比较无差异),且观察组降低或升高程度均大于对照组(P<0.05或P<0.01)。观察组不良反应总发生率为5.26%,低于对照组的21.62%(χ2=4.341,P=0.037)。结论蛇毒血凝酶联合维生素K 1治疗新生儿消化道出血的临床效果肯定,可有效改善症状与凝血功能指标,且用药安全性高。Objective To observe the clinical efficacy of hemocoagulase combined with VK 1 in the treatment of neonatal gastrointestinal bleeding.Methods A retrospective analysis was conducted on 75 neonates with gastrointestinal bleeding admitted to Sanming First Hospital Affiliated to Fujian Medical University from March 2022 to March 2024.Based on different treatment regimens,patients were divided into an observation group(n=38)and a control group(n=37).In addition to routine treatment,the control group received Vitamin K 1 injection,while the observation group received hemocoagulase injection in addition to Vitamin K 1 injection.Both groups were treated for 3 days,and the treatment efficacy,time to improvement of symptoms(hematemesis,melena,abdominal distension,etc.),fecal occult blood test turning negative time,and changes in coagulation function indicators(PAI-1,TT,APTT,Fib,D-D,t-PA)before and after 3 days of treatment,as well as adverse reactions were compared between the two groups.Results The overall effective rate of the observation group was 97.37%,significantly higher than that of the control group(83.78%)(χ2=4.088,P=0.043).Patients in the observation group had shorter symptom improvement time and fecal occult blood test turning negative time compared with the control group(P<0.01).After 3 days of treatment,TT,APTT,and t-PA in both groups decreased compared with before treatment,while other indicators increased.Except for PAI-1,there were significant differences in all other indicators between the two groups(P<0.05 or P<0.01),and the observation group showed a greater decrease or increase than the control group.The overall incidence of adverse reactions in the observation group was 5.26%,significantly lower than that of the control group(21.62%)(χ2=4.341,P=0.037).Conclusion The study demonstrates that the combined treatment of hemocoagulase and VK 1 significantly improves clinical outcomes in neonates with gastrointestinal bleeding,as evidenced by reductions in symptom duration and alterations in coagulation fu

关 键 词：消化道出血 新生儿 蛇毒血凝酶 维生素K 1 治疗效果 症状改善 凝血功能 

分 类 号：R722.1[医药卫生—儿科]