晚发型维生素K缺乏性出血症的临床分析及预防对策

目的 分析晚发型维生素K缺乏性出血症(VKDB)的临床特征,并总结其预防对策.方法 将2019年9月至2021年8月本院收治的100例晚发型VKDB患儿设为观察组,选取同期于本院出生的100名健康婴儿为对照组,两组均展开凝血功能指标(PT、APTT、TT、CT)、维生素K缺乏诱导蛋白-Ⅱ(PIVKA-Ⅱ)、维生素K1(...

Clinical analysis and preventive measures of late-onset vitamin K deficiency bleeding

Objective To analyze the clinical features of late-onset vitamin K deficiency bleeding(VKDB)and summarize preventive measures.Methods One hundred children with late-onset VKDB treated in our hospital from September 2019 to August 2021 were set as observation group,and 100 healthy infants born in our hospital at the same time were selected as control group.Coagulation function indexes(PT,APTT,TT,CT),vitamin K deficiency inducing protein-Ⅱ(PIVKA-Ⅱ),vitamin K₁(VK₁),plasma des-γ-carboxy-pothrombin(DCP),serum antidiuretic hormone(ADH)and electrolytes(Na⁺,Cl^-,Mg²⁺,Ca²⁺)levels of the two groups were detected.The above indexes of the control group and the observation group were compared.According to the existence of coma,the children in the observation group were divided into conscious group(n=46)and comatose group(n=54).The above indexes of the two groups were compared.Results The PT,APTT,TT and CT of the observation group were significantly longer than those of the control group,the level of PIVKA-Ⅱwas significantly higher than that of the control group,the level of VK₁ was significantly lower than that of the control group,and the differences were statistically significant(P<0.05).The levels of DCP and ADH in the observation group were significantly higher than those in the control group,the levels of Na⁺,Cl^-,Mg²⁺and Ca²⁺ were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The PT,APTT,TT and CT in the comatose group were significantly longer than those in the conscious group,PIVKA-Ⅱlevel was significantly higher than that in the conscious group,VK₁ level was significantly lower than that in the conscious group,and the differences were statistically significant(P<0.05).The levels of DCP and ADH in the comatose group were significantly higher than those in the conscious group,the levels of Na⁺,Cl^-,Mg²⁺ and Ca²⁺ were significantly lower than those in the conscious group,and the differences were statistically significant(P<0.05).Conclusion Late-onset VKDB has coagulation dysfunction,which is characterized by prolonged PT,APTT,TT and CT,increased levels of DCP,ADH and PIVKA-Ⅱ,and decreased levels of VK₁ and related electrolytes.The detection of the above indexes can provide a certain reference for the diagnosis and prevention of the disease.