胃肠外科新生儿围术期凝血功能异常的影响因素分析

发布时间：2018-04-16 13:10

  本文选题：凝血功能异常 + 新生儿　； 参考：《临床麻醉学杂志》2017年08期

【摘要】：目的分析胃肠外科新生儿围术期凝血功能异常的影响因素。方法回顾性分析2012年6月至2016年4月胃肠外科323例新生儿凝血指标,包括血浆凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)、凝血酶时间(TT)和血浆纤维蛋白原(Fib)以及围术期相关临床资料,分析围术期凝血功能异常相关危险因素。结果术后4h内凝血指标异常新生儿158例,其中轻度异常61例,明显异常97例。多元Logistic回归分析显示,术前合并肺炎(OR=2.880,95%CI 1.417~5.852)、围术期低钙(OR=2.381,95%CI 1.167~4.857)、有创穿刺置管(OR=2.490,95%CI 1.299~4.773)是新生儿术后4h内凝血指标异常的独立危险因素(P0.05)。结论在围术期管理时,应积极治疗肺炎、纠正低钙血症及选用浓度低于6.25U/ml的肝素溶液或生理盐水护理动静脉,以减少新生儿术后凝血功能异常的发生。
[Abstract]:Objective to analyze the influencing factors of peri-operative abnormal coagulation function of neonates in gastrointestinal surgery.Methods from June 2012 to April 2016, 323 cases of neonatal coagulation in gastrointestinal surgery were retrospectively analyzed.Plasma prothrombin time (PTT), partial activated thromboplastin time (APTT), thrombin time (TTT) and plasma fibrinogen (Fib) were included.Results 158 cases of neonates with abnormal coagulation indexes were found within 4 hours after operation, among which 61 cases were mild abnormal and 97 cases were obviously abnormal.Multivariate Logistic regression analysis showed that preoperative complications with pneumonia were 2.880 ~ 95CI 1.417 ~ 5.852C, perioperative low calcium level 2.381C _ (95) CI 1.167 ~ 4.857 and invasive puncture catheterization 2.490 ~ 95CI 1.299 ~ 4.773) were independent risk factors of abnormal blood coagulation index within 4 hours after operation (P0.05).Conclusion during perioperative management, pneumonia should be treated actively, hypocalcemia should be corrected and arteriovenous nursing should be taken with heparin solution or normal saline with concentration lower than 6.25U/ml in order to reduce the incidence of abnormal coagulation function after operation.
【作者单位】： 重庆医科大学附属儿童医院;重庆医科大学附属第三医院;
【分类号】：R726.5
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本文编号：1759056