早产儿凝血功能监测的临床意义及护理

目的 观察早产儿凝血酶时间（TT）、凝血酶原时间（PT）、部分凝血酶时间（APTT）及纤维蛋白原（FBG）等凝血四项检测及对凝血功能异常早产儿实施护理干预的效果.方法 选择2013年4月至2014年3月我科收治400例早产儿作为观察组,并于出生后24 h内抽取股静脉血检测TT、PT、APTT及FBG等凝血指标,同时采取保温护理、感染护理、喂养护理、呼吸护理等措施;然后把选取同年段的400例正常足月儿作为对照组,同样出生后24 h内检测凝血四项,但只采取常规护理.比较两组检测与护理后疗效的差异性.结果 观察组新生儿凝血四项测定显示TT为（17.46±4.6）s,PT为（15.01±3.85）s,APTT为（62.31±7.12）s,FBG为（2.01±0.92）g/L;而对照组TT为（14.43±1.67）s,PT为（10.46±2.81）s,APTT为（32.37±2.01）s,FBG为（2.22±0.67）g/L.可见观察组早产儿胎龄和体重越低,则PT、TT和APTT就会延长,其FBG降低就越明显,说明观察组发生出血性疾病的比例明显高于对照组（P＜0.05）.但观察组经治疗和护理后,有399例健康出院,1例因并发症严重死亡;而对照组有3例转入其他医院,余397例经长时间护理后也全部健康出院.结论 加强早产儿凝血四项检测,并采取正确治疗和相应的护理措施,可避免早产儿并发症的发生,提高早产儿生存率.

Clinical significance of monitoring coagulation function of premature infants and their nursing care

Objective To observe the detection of TT,PT,APTT,and FBG in premature infants and the effect of nursing intervention on premature infants.Methods 400 cases admitted into our department from April,2013 to March,2014 were selected as an observation group.Their TT,PT,APTT,FBG,etc.were detected within 24 hours＇ birth.And nursing care measures such as warmth keeping,infection care,feeding care,breathing care,etc.were carried out on them.Other 400 cases were selected from the same period as a control group.Their TT,PT,APTT,FBG,etc.were detected within 24 hours＇ birth.They received routine nursing care.The efficacies of the 2 groups were compared.Results The TT,PT,APTT,and FBG were （17.46 ± 4.6） s,（15.01 ± 3.85） s,（62.31 ± 7.12） s,and （2.01 ± 0.92）g/L in the observation group and were （14.43 ± 1.67）s,（10.46 ± 2.81） s,（32.37 ± 2.01） s,and （2.22 ± 0.67） g/L in the control group,respectively.The smaller the observation group＇ infants＇ gestational age was and the lighter their birth weight was,the longer their PT,TT,and APTT were and the lower their FBG was,showing that more infants got hemorrhagic diseases in the observation group than in the control group（P〈0.05）.However,after the treatment and nursing care,399 cases discharged from the hospital healthy and 1 case died from severe complication in the observation group; 3 cases were transferred to other hospital and the rest 397 cases discharged healthy after long time nursing care.Conclusions Coagulation testing and appropriate corresponding nursing care can prevent complications＇ happening and increase the infants＇ survival rate.