新生儿败血症合并早期弥散性血管内凝血相关因素的临床研究

Risk factors for early disseminated intravascular coagulation in neonates with sepsis

摘要:

目的 探讨新生儿败血症合并早期弥散性血管内凝血(DIC)的相关临床因素,为临床早期诊断新生儿败血症合并DIC 提供参考。方法 采用临床回顾研究方法对我院NICU 2012~2013 年确诊为新生儿败血症的100 例患儿进行研究。根据ISTH 显性DIC 评分系统将患儿分为凝血功能正常组、非显性DIC 组(早期DIC 组)及显性DIC 组(晚期DIC 组),对各组临床表现及相关临床因素进行统计分析。结果 100 例败血症患儿中合并早期DIC 者44 例(44%);3 组患儿硬肿的发生率差异有统计学意义(χ²=12.776,P<0.05);窒息、出血及G- 菌感染是败血症合并早期DIC 的独立危险因素。结论 对于临床有窒息、出血及G- 菌感染的新生儿应积极监测凝血功能并采取早期干预措施,预防患儿由早期DIC 进展为晚期DIC,降低新生儿败血症的病死率。

Abstract:

Objective To investigate the risk factors for early disseminated intravascular coagulation (DIC) in neonates with sepsis. Methods A retrospective clinical study was performed on 100 neonates with a confirmed diagnosis of sepsis between 2012 and 2013. The children were classified into normal coagulation group, non-overt DIC group (early DIC group), and overt DIC group (late DIC group) based on the ISTH overt DIC scoring system. The clinical manifestations and risk factors were analyzed statistically. Results Early DIC occurred in 44 (44%) cases in the 100 neonates with sepsis. The incidence of sclerema showed significant differences between the three groups (P<0.05). Asphyxia, bleeding, and Gram-negative bacterial infection were independent risk factors for early DIC. Conclusions Coagulation function should be actively monitored and early intervention measures should be taken for neonates with asphyxia, bleeding, and Gram-negative bacterial infection to prevent early DIC from progressing to late DIC.