早产儿凝血功能障碍的高危因素分析及其相关问题临床研究

发布时间：2018-03-18 14:01

本文选题：早产儿　切入点：凝血功能障碍　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:了解不同高危因素对早产儿凝血功能障碍的影响,分析早产儿凝血功能障碍与临床出血的关系,探讨早产儿凝血功能障碍与肝功能的关系,并了解极早早产儿和早期早产儿的凝血功能指标特点。方法:纳入2015年1月到2016年12月期间在我院新生儿重症监护室住院治疗的早产儿600例,按照凝血功能检测指标分为两组:凝血功能正常组(190例)及凝血功能障碍组(410例)。1)对早产儿凝血功能障碍相关因素作单因素分析,并将单因素分析中有意义的因素纳入Logistic回归模型进行多因素检验。2)分别比较临床是否出血及脑室内出血的严重程度在两组间的差异。3)比较肝功能指标在两组间的差异。4)统计分析极早早产儿和早期早产儿常见凝血试验结果。结果:1)单因素分析中,孕母妊娠期高血压疾病、窒息、胎盘早剥、宫内感染、小于胎龄儿、呼吸窘迫、出生体重在两组间差异有统计学意义(P0.05)。多因素分析中,孕母妊娠期高血压等六项因素在两组间比较差异有统计学意义(P0.05),呼吸窘迫在凝血功能障碍组与正常组间差异无统计学意义(P0.05)。2)临床是否出血在两组间差异有统计学意义(P0.05),而脑室内出血及严重程度在两组间差异无统计学意义(P0.05)。3)肝功能中白蛋白、碱性磷酸酶在两组间比较差异有统计学意义(P0.05)。4)极早早产儿凝血酶原时间、部分活化凝血酶原时间、纤维蛋白原,其均数±标准差分别为18.8±4.0(s)、77.3±23.5(s)、1.9±1.1(g/L);早期早产儿分别为17.4±3.8(s)、66.7±21.3(s)、2.1±1.2(g/L)。结论:1)孕母妊娠期高血压、窒息、胎盘早剥、宫内感染、出生体重、小于胎龄儿与早产儿凝血功能障碍密切相关。2)早产儿凝血功能障碍与临床上发生出血有关,但凝血功能障碍与脑室内出血及其严重程度并无相关性。3)早产儿凝血功能水平不仅与肝脏白蛋白合成功能有关,还与碱性磷酸酶水平有关。4)极早早产儿和早期早产儿凝血功能较轻型早产儿更低,有更大的出血风险。
[Abstract]:Objective: To investigate the effects of different risk factors on premature coagulation function, blood coagulation dysfunction and clinical analysis of the relationship between premature bleeding, to explore the relationship between hepatic dysfunction and coagulation function in premature infants, and to understand the extremely preterm and early preterm infants blood coagulation characteristics. Methods: from January 2015 to December 2016 in the hospital treatment of 600 cases of premature infants in the neonatal intensive care unit in our hospital, according to the detection indexes of blood coagulation function were divided into two groups: normal blood coagulation function group (190 cases) and coagulopathy group (410 cases).1) related factors on premature coagulation dysfunction as the single factor analysis, and the prognostic factors in univariate analysis into Logistic regression model for multivariate test.2) compare the clinical severity of bleeding and intraventricular hemorrhage in the difference between the two groups.3) liver function indexes in the two groups of difference ISO.4) statistical analysis of extremely preterm and early preterm infants common coagulation tests. Results: 1) univariate analysis, maternal pregnancy induced hypertension, placental abruption, asphyxia, intrauterine infection, gestational age, respiratory distress, birth weight difference between the two groups has statistical significance (P0.05). In multivariate analysis, maternal gestational hypertension in six factors such as the difference between the two groups was statistically significant (P0.05), respiratory distress was no statistically significant difference in blood coagulation dysfunction group and normal group (P0.05).2) clinical bleeding in two was statistically significant difference between the groups (P0.05), no statistically significant the significance of intraventricular hemorrhage and severity in the difference between the two groups (P0.05).3) albumin liver function, alkaline phosphatase in comparison was statistically significant difference between the two groups (P0.05).4) extremely preterm prothrombin time, activated partial thromboplastin time, fiber Fibrinogen, the standard deviation was 18.8 + 4 (s), 77.3 + 23.5, 1.9 + 1.1 (s) (g/L); early preterm infants were 17.4 + 3.8 (s), 66.7 + 21.3, 2.1 + 1.2 (s) (g/L). Conclusion: 1) maternal pregnancy hypertension, placental abruption, asphyxia, intrauterine infection, birth weight, gestational age and preterm infants blood coagulation dysfunction is closely related to.2) and the clinical occurrence of coagulopathy bleeding, coagulopathy and intraventricular hemorrhage but no correlation between.3 and severity) level of coagulation function in premature infants is not only related with the liver albumin synthesis function. With the level of alkaline phosphatase.4) extremely preterm and early preterm infants with lower coagulation lighter, have a greater risk of bleeding.

【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R722.6

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