|
|
|
| Therapeutic effect of low-dose heparin in newborn with coagulation disorders |
| ZANG Lili WANG Zhao LI Xiaoxiang LI Lihua |
| Children′s Center, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China |
|
|
|
Abstract Objective To investigate the therapeutic effect of low-dose heparin in newborn with coagulation disorders. Methods A total of 70 neonates with coagulation disorders treated in Department of Neonatology of Beijing Luhe Hospital, Capital Medical University from August 2016 to July 2017 were selected and were divided into control group (n = 35 cases) and observation group (n = 35 cases) according to random number table. The control group was given general treatment such as reasonable milking or parenteral nutrition support and appropriate blood product administration, the observation group was given a small dose of heparin sodium on the basis of the control group. The prothrombin time (PT), thrombin time (TT), fibrinogen (FBI), activated partial thromboplastin time (APTT), platelet count (PLT), and D-dimer (D-D) were determined at three different time points at 24, 48, and 72 h after treatment. The complications, cure rate, and mortality of the two groups were recorded, and the clinical efficacy, coagulation index, and prognosis of the two groups were compared. Results The effective rate of observation group 72 h after treatment was higher than the control group, the difference was statistically significant (P < 0.05). There was no statistically significant difference in the levels of PT, TT, FBI, APTT, PLT and D-D between the two groups before and 24 h after the treatment (P > 0.05). The levels of PT, TT, APTT and D-D in the observation group at 48 and 72 h after treatment were lower than those in the control group, the differences were statistically significant (P < 0.05); the levels of FBI and PLT in the observation group 72 h after treatment were higher than those in the control group, the differences were statistically significant (P < 0.05). The levels of PT, TT, APTT and D-D of the two groups after treatment showed a decreasing trend, which were lower than before treatment, the differences were statistically significant (P < 0.05). The levels of FBI and PLT of the observation group were higher than those of the control group, the differences were statistically significant (P < 0.05). The incidence rate of intracranial hemorrhage, pulmonary hemorrhage, gastrointestinal hemorrhage and mortality after treatment were all lower than those in the control group, the differences were statistically significant (P < 0.05). Conclusion The combination of low-dose heparin on the basis of conventional treatment can help improve clinical efficacy of neonatal coagulopathy, improve patients′ coagulation function, reduce the incidences of complications and mortality, and it is worthy of popularization and application.
|
|
|
|
|
|
[1] 刘刚，魏秀玲，杨林江，等.中度高海拔地区肺部手术后早期使用低分子肝素抗凝对凝血功能的影响及安全性[J].广东医学，2016，37（6）：871-873.
[2] 邹婷婷，杜敏，徐颖.胃肠外科新生儿围术期凝血功能异常的影响因素分析[J].临床麻醉学杂志，2017，33（8）：760-764.
[3] 张文喜，段达荣，张震宇，等.参附注射液联合低分子肝素对小儿脓毒血症血浆NT-ProBNP、Cys、凝血功能和预后的影响[J].中国现代医学杂志，2017，27（2）：61-65.
[4] Hunt KJ，Baker NL，Cleary PA，et al. Longitudinal association between endothelial dysfunction，inflammation，and clotting biomarkers with subclinical atherosclerosis in type 1 diabetes：an evaluation of the DCCT/EDIC Cohort [J]. Diabetes Care，2015，38（7）：1281.
[5] 韩红卫，丁盛，陈红.出生后24h凝血功能异常新生儿临床表现及影响因素分析[J].临床儿科杂志，2015，33（2）：141-143.
[6] 宋小燕，陈红武，廖卫华，等.亚低温治疗对不同程度缺氧缺血性脑病新生儿凝血功能的影响[J].中华实用儿科临床杂志，2017，32（12）：903-907.
[7] 俞钢，张小庄，陈运彬.胎儿新生儿外科疾病诊断治疗图谱[M].广州：暨南大学出版社，2008.
[8] 万刚.高原地区早产儿凝血功能分析与输血浆后疗效观察[J].世界最新医学信息文摘：连续型电子期刊，2016， 16（21）：71-72.
[9] Wang B，Wu S，Wang T，et al. Bone marrow-derived mesenchymal stem cells-mediated protection against organ dysfunction in disseminated intravascular coagulation is associated with peripheral immune responses [J]. J Cell Biochem，2017，118（10）：3184.
[10] 袁景春.维生素K1、酚磺乙胺联合治疗新生儿凝血功能障碍的疗效观察[J].实用妇科内分泌杂志：电子版，2017，4（21）：32-33.
[11] 覃安志，曾美红，郑志勇，等.维生素K1和酚磺乙胺治疗新生儿凝血功能障碍效果分析[J].儿科药学杂志，2015， 21（7）：30-33.
[12] 李卿，王丽林.低分子肝素钠抗凝在肝硬化合并门静脉血栓中的应用效果[J].中国医药导报，2018，15（4）：69-72.
[13] 周冬莲，刘清霞，曾小燕.低分子肝素钠同步全程抗凝对肺癌患者PICC置管后的护理观察[J].中国现代医生，2017，55（24）：144-147.
[14] 李洪书.低分子肝素钠联合压力袜在预防妇科盆腔术后下肢深静脉血栓的临床研究[J].中国医药科学，2017， 7（21）：205-208.
[15] 赵嵩，安莲英，彭丽霞，等.子痫前期患者应用低分子肝素钠辅助治疗对其凝血功能及肾功能的影响[J].疑难病杂志，2016，15（157）：716-719.
[16] 苏国生，黄积德，梁荣伟，等.维生素K1、酚磺乙胺联合治疗新生儿凝血功能障碍的疗效观察[J].重庆医学，2013， 42（2）：180-182.
[17] 赵锦英，蒋晓梅，蒙淑芳.微剂量肝素联合冷沉淀治疗新生儿弥散性血管内凝血的临床效果分析[J].转化医学电子杂志，2017，4（6）：43-45，48.
[18] 许丽娜.新生儿早期DIC的治疗体会[J].世界最新医学信息文摘，2018，18（4）：61-64.
[19] 屠志琴.维生素K1和酚磺乙胺联合治疗新生儿凝血功能障碍的疗效分析[J].中国妇幼保健，2014，29（34）：5721-5722.
[20] 王文华，徐丁，韩亚梅，等.新生儿败血症合并早期弥散性血管内凝血相关因素的临床研究[J].中国当代儿科杂志，2015，17（4）：341-344.
[21] Woldu MA，Guta MB，Lenjisa JL，et al. Assessment of the incidence of neonatal sepsis，its risk factors，antimicrobials use and clinical outcomes in bishoftu general hospital，neonatal intensive care unit，debrezeit-ethiopia [J]. Brit J Ophthalmol，2017，4（4）：496-501.
[22] Kalathottukaren MT，Abraham L，Kapopara PR，et al. Alteration of blood clotting and lung damage by protamine are avoided using the heparin and polyphosphate inhibitor UHRA [J]. Blood，2017，129（10）：1368-1379.
[23] Hong X，Shan PR，Huang WJ，et al. Influence of body mass index on the activated clotting time under weight-based heparin dose [J]. J Clin Lab Anal，2016，30（2）：108-113.
[24] Acosta RD，Abraham NS，Chandrasekhara V，et al. The management of antithrombotic agents for patients undergoing GI endoscopy.[J]. Gastrointest Endosc，2016，83（1）：3-16.
[25] 段红丽，洪小山.低分子肝素治疗重度子痫前期合并胎儿生长受限疗效观察[J].中国医药科学，2016，6（24）：81-83.
[26] 朱薏，路妍妍，田耕.丹参注射液与低分子肝素治疗胎儿生长受限的临床疗效比较[J].现代医院，2016，16（4）：483-485. |
|
|
|
