發(fā)布時(shí)間：2018-04-16 13:10

  本文選題：凝血功能異常 + 新生兒�。� 參考：《臨床麻醉學(xué)雜志》2017年08期

【摘要】：目的分析胃腸外科新生兒圍術(shù)期凝血功能異常的影響因素。方法回顧性分析2012年6月至2016年4月胃腸外科323例新生兒凝血指標(biāo),包括血漿凝血酶原時(shí)間(PT)、部分活化凝血活酶時(shí)間(APTT)、凝血酶時(shí)間(TT)和血漿纖維蛋白原(Fib)以及圍術(shù)期相關(guān)臨床資料,分析圍術(shù)期凝血功能異常相關(guān)危險(xiǎn)因素。結(jié)果術(shù)后4h內(nèi)凝血指標(biāo)異常新生兒158例,其中輕度異常61例,明顯異常97例。多元Logistic回歸分析顯示,術(shù)前合并肺炎(OR=2.880,95%CI 1.417~5.852)、圍術(shù)期低鈣(OR=2.381,95%CI 1.167~4.857)、有創(chuàng)穿刺置管(OR=2.490,95%CI 1.299~4.773)是新生兒術(shù)后4h內(nèi)凝血指標(biāo)異常的獨(dú)立危險(xiǎn)因素(P0.05)。結(jié)論在圍術(shù)期管理時(shí),應(yīng)積極治療肺炎、糾正低鈣血癥及選用濃度低于6.25U/ml的肝素溶液或生理鹽水護(hù)理動(dòng)靜脈,以減少新生兒術(shù)后凝血功能異常的發(fā)生。
[Abstract]:Objective to analyze the influencing factors of peri-operative abnormal coagulation function of neonates in gastrointestinal surgery.Methods from June 2012 to April 2016, 323 cases of neonatal coagulation in gastrointestinal surgery were retrospectively analyzed.Plasma prothrombin time (PTT), partial activated thromboplastin time (APTT), thrombin time (TTT) and plasma fibrinogen (Fib) were included.Results 158 cases of neonates with abnormal coagulation indexes were found within 4 hours after operation, among which 61 cases were mild abnormal and 97 cases were obviously abnormal.Multivariate Logistic regression analysis showed that preoperative complications with pneumonia were 2.880 ~ 95CI 1.417 ~ 5.852C, perioperative low calcium level 2.381C _ (95) CI 1.167 ~ 4.857 and invasive puncture catheterization 2.490 ~ 95CI 1.299 ~ 4.773) were independent risk factors of abnormal blood coagulation index within 4 hours after operation (P0.05).Conclusion during perioperative management, pneumonia should be treated actively, hypocalcemia should be corrected and arteriovenous nursing should be taken with heparin solution or normal saline with concentration lower than 6.25U/ml in order to reduce the incidence of abnormal coagulation function after operation.
【作者單位】： 重慶醫(yī)科大學(xué)附屬兒童醫(yī)院;重慶醫(yī)科大學(xué)附屬第三醫(yī)院;
【分類號(hào)】：R726.5
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本文編號(hào)：1759056