目的 分析不同胎龄早产儿凝血功能及颅内出血影响因素.方法 选择500例早产儿纳入早产儿组,根据胎龄分为早期早产儿组和晚期早产儿组;根据是否颅内出血分为出血组和未出血组.同期选择足月健康新生儿250例为对照组.比较各组血浆凝血酶原时间(PT)、血浆纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、D-二聚体(DD)、颅内出血发生率.采用多因素Logistic回归分析早产儿出现颅内出血的影响因素.结果 早期早产儿组、晚期早产儿组PT、APTT、DD、颅内出血发生率高于对照组,FIB低于对照组,且早期早产儿组较晚期早产儿组更为显著(P＜0.05).出血组早产儿5 min Apgar评分、胎龄、出生体质量、FIB低于未出血组,胎内窘迫、PS治疗、机械通气占比、PT、APTT高于未出血组(P＜0.05).胎内窘迫、PS治疗、机械通气占比、PT、APTT、5 min Apgar评分、胎龄、出生体质量、FIB均为颅内出血影响因素(P＜0.05).结论 早产儿多出现凝血功能紊乱,其颅内出血的影响因素较多,早期干预有助于降低早产儿颅内出血发生率.
Comparison of coagulation function in premature infants of different gestational ages and a-nalysis of factors to influence intracranial hemorrhage
Aim To analyze the factors to influence coagulation function and intracranial hemorrhage in premature infants of different gestational ages.Methods 500 premature infants were selected and divided into early premature infants and late prema-ture infants according to gestational age.According to whether there is intracranial hemorrhage or not,they were divided into bleeding group and non-bleeding group.At the same time,250 full-term healthy newborns were selected as the control group.Plasma pro-thrombin time(PT),plasma fibrinogen(FIB),activated partial thromboplastin time(APTT),D-dimer(DD)and incidence of in-tracranial hemorrhage were compared among the groups.Multivariate Logistic regression was used to analyze the factors influencing intracranial hemorrhage in premature infants.Results The incidence of PT,APTT,DD and intracranial hemorrhage in early pre-mature infants and late premature infants was higher than that in the control group,while FIB was lower than that in the control group,and the incidence in early premature infants was more significant than that in late premature infants(P＜0.05).The 5-minute Apgar score,gestational age,birth weight and FIB of premature infants in bleeding group were lower than those in non-bleeding group,while the fetal distress,PS therapy,mechanical ventilation rate,PT and APTT were higher than those in non-bleeding group(P＜0.05).Fetal distress,PS therapy,mechanical ventilation,PT,APTT,5 min Apgar score,gestational age,birth weight and FIB were all fac-tors influencing intracranial hemorrhage(P＜0.05).Conclusion Premature infants often have coagulation dysfunction,and there are many factors to influence intracranial hemorrhage.Early intervention is helpful to reduce the incidence of intracranial hemorrhage in premature infants.
万方数据
维普
