早产儿凝血功能及颅内出血关系探究.docVIP

早产儿凝血功能及颅内出血关系探究 　 作者：张旭东，韩锦玲，赖龙龙，周敏，李汉 【摘要】 目的：探讨早产儿凝血功能与颅内出血的关系。方法：对我科住院的123名早产儿凝血功能状态进行回顾性分组分析，检测凝血酶原时间（PT）、部分活化凝血活酶时间（APTT）、纤维蛋白原（FIB）含量、血小板数（PBC）及头颅CT，分析发生颅内出血的几率，以及胎龄与颅内出血两者的相关性。结果：早产儿均不同程度存在凝血功能低下情况，与足月儿比较差异有统计学意义，根据胎龄大小分组分析进行统计检验，发现胎龄越低凝血功能低下程度越严重，发生颅内出血比率越高，早产儿中颅内出血发生57例，占早产儿总数的46.3%，胎龄与早产儿颅内出血呈显著负相关(γ=-0.338，Plt;0.01)。讨论：凝血功能低下是早产儿常见并发症，是发生颅内出血的重要原因之一，胎龄越低凝血功能低下越严重，颅内出血发生率越高。 【关键词】 早产儿；凝血功能；颅内出血 ［Abstract］ Objective:To study the relationship between premature infants with low blood coagulation and intracranial hemorrhage.Methods:We took a retrospective group analysis for the coagulation state of the 123 hospitalized premature infants, by the detections of prothrombin time (PT), parttime activation thromboplastin (APTT), fibrinogen (FIB) content, platelet count (PBC) and head CT, to study the relationship between probability of occurrence of intracranial hemorrhage and gestational age.Results: Compared with fullterm infants, the premature infants had varying degrees of lower blood coagulation showing a significant difference. An inspection, based on the gestational age group, found that the lower the gestational age was, the lower the level of blood coagulation would be and the higher the occurrence rate of intracranial hemorrhage was. There were 57 cases of intracranial hemorrhage in premature infants, taking as high as 46.3% of the total number of premature infants. There was a negative correlation between gestational age and intracranial hemorrhage in premature infants (γ=-0.338, Plt;0.01). Conclusions:Lower blood coagulation is common complication in premature infants, which is one of important reasons for the occurrence of infant intracranial hemorrhage. The lower the gestational age of the infant is, the lower the blood coagulation function is and the higher the rate of intracranial hemorrhage is. ［Key words］ Premature infants;Blood coagulation;Intracranial hemorrhage 早产儿发生颅内出血（ICH）的比例远比足月儿高，有研究表明，在孕龄不足32周或体重小于1 500 g的低出生儿中，颅内出血的发病率可达40%～50%，死亡率