本文選題：凝血功能障礙 + 新生兒　； 參考：《重慶醫(yī)科大學》2017年碩士論文

【摘要】：目的:分析胃腸外科新生兒圍術期凝血功能變化的影響因素。方法:回顧性調(diào)查分析2012年6月~2016年4月我院胃腸新生兒外科的323例新生兒凝血指標[血漿凝血酶原時間(PT)、部分活化凝血活酶時間(APTT)、凝血酶時間(TT)及血漿纖維蛋白原(Fib)]及圍術期相關臨床資料,根據(jù)術后4小時內(nèi)凝血指標結(jié)果分為輕度異常組、明顯異常組及正常組,分析三組術后4小時內(nèi)凝血指標的差異,并分析圍術期凝血功能障礙相關危險因素。結(jié)果:術后4小時內(nèi)凝血指標異常新生兒158例,其中輕度異常61例,明顯異常97例,單因素分析結(jié)果顯示三組新生兒年齡、術前合并肺炎、腹膜炎、手術級別、手術時間、術中有創(chuàng)穿刺置管、輸注紅細胞懸液(RBC)及羥乙基淀粉、圍術期低鈣差異具有統(tǒng)計學意義(P0.05)。多元logistic回歸分析結(jié)果顯示:術前合并肺炎、圍術期低鈣、有創(chuàng)穿刺置管是新生兒術后4小時內(nèi)凝血指標異常的獨立危險因素(P0.05)。結(jié)論:在圍術期管理時,應積極治療肺炎、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理動靜脈,以減少新生兒術后凝血功能障礙的發(fā)生。
[Abstract]:Objective: to analyze the factors influencing the changes of coagulation function during the perioperative period of neonatal surgery in gastrointestinal surgery. Methods: a retrospective study was conducted to analyze the blood coagulation parameters [plasma prothrombin time (PT), partial activated thromboplastin time (APTT), thrombin time (TT) and plasma fibrinogen (Fib) in 323 cases of neonatal surgery in our hospital in June 2012 ~2016 years. The related clinical data of perioperative period were divided into mild abnormal group, obvious abnormal group and normal group according to the results of coagulation index within 4 hours after operation. The difference of coagulation indexes within 4 hours after operation was analyzed in the three groups, and the risk factors related to coagulation dysfunction during the perioperative period were analyzed. Results: 158 cases of abnormal coagulation index in 4 hours after operation were mild. Abnormal 61 cases, obviously abnormal 97 cases, single factor analysis showed that the age of three groups of newborns, preoperative combined pneumonia, peritonitis, operation level, operation time, invasive puncture tube, infusion of red cell suspension (RBC) and hydroxyethyl starch, the difference of low calcium in perioperative period was statistically significant (P0.05). Multivariate logistic regression analysis showed: preoperative Combined pneumonia, perioperative hypocalcemia and invasive catheterization are independent risk factors for abnormal coagulation index within 4 hours after the operation of the newborn (P0.05). Conclusion: during the perioperative management, we should actively treat pneumonia, correct hypocalcemia and use heparin solution or saline solution of lower concentration than 6.25u/ml to nurse the blood and vein in order to reduce the postoperative coagulation work of the newborns. An obstacle can happen.

【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R726.1

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