晚发性维生素K缺乏所致颅内出血8年回顾与分析

目的 　了解晚发性维生素K缺乏所致的严重出血 ,特别是颅内出血 ,预后凶险 ,如治疗不及时 ,不仅病死率高 ,而且存活者可能有不同程度的神经系统后遗症等临床特点及如何防治。方法 　从 1 996年 1月～ 2 0 0 3年 1 2月 ,8年间大连市儿童医院共救治 1 1 9例患儿 ,现进行临床总结。结果 　早期住院治疗应用维生素K1者 ,凝血酶原时间恢复正常的时间短、易治愈。本组 6 1例治愈 (占 51 2 % ) ;因经济困难好转4 0例 (占 33 6 % ) ,放弃治疗 1 1例 (占 9 3% )。因发病时间长、就诊时间晚 ,失去抢救时机而死亡 7例 (占 5 9% )。结论 　本病病因是维生素K缺乏 ,母乳喂养易发生本病。慢性腹泻、维生素K依赖是常见的临床症状之一。当体内凝血酶原减低时 ,可见出血倾向 ,颅内出血以蛛网膜下腔出血为主。如果早期就医、确诊 ,是可以治愈的。如果早期预防 ,在出生后、1个月、3个月各注射 1次维生素K11～ 3mg效果最佳 ,可以减少本病的发生。

Eight years review and analysis of late form of vitamin K deficiency and intracranial haemorrhage

Objective Background Haemorhage especially intracranial haemorrhage that due to the late form of vitamin K deficiency is dangerous on prognosis. If it does not be treated in time,the mortality rate is high, and the survivor may get neurological damage in various degrees. Method There 119 reported cases between l996 and 2003 from Dalian Children's Hospital. Now,we summarize as follows. Result Prothrombin time of the cases that were administered Vitamin K_1 early is short,and those cases were easy to be healed. In these group,61 infants (51.2%) were healed,40 infants'(33.6%) condition took a favorable turn,11 infants (9.3%)gave up to be treated,and 7 infants(5.9%) dead because of long course of diseases,delaying to see a doctor and thus lost the opportunity of rescue. Conclusion Hemorrhagic disorder occurs as a result of vitamin K deficiency;breast-fed infants are apt to develop this deficiency. Chronic diarrhea and vitamin K dependence are common clinical symptoms. When prothrombin decreases,the body is at the great risk for bleeding,subarachnoid age is most common. If seek medical advice and make definite diagnosis early,it can cure. We suggest that vitamin K prophylaxis is needed to all infants,inject vitamin K_11-3 mg,at 1 month,and then,at 3 month of age is an effective way and will largely prevent hemorrhagic disease.