[1]白 静,侯兴宁,兰海琴.新生儿凝血危急值在临床实践中的应用以及正常参考范围的调查分析[J].现代检验医学杂志,2017,32(01):150-153.[doi:10.3969/j.issn.1671-7414.2017.01.042]
　BAI Jing,HOU Xing-ning,LAN Hai-qin.Critical Values of Neonatal Coagulation in Clinical Practice and the Investigation of Normal Reference Range[J].Journal of Modern Laboratory Medicine,2017,32(01):150-153.[doi:10.3969/j.issn.1671-7414.2017.01.042]
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新生儿凝血危急值在临床实践中的应用以及正常参考范围的调查分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第32卷
期数:
2017年01期
页码:
150-153
栏目:
检验与临床
出版日期:
2017-01-25

文章信息/Info

Title:
Critical Values of Neonatal Coagulation in Clinical Practice and the Investigation of Normal Reference Range
文章编号:
1671-7414(2017)01-150-04
作者:
白 静; 侯兴宁; 兰海琴
宁夏医科大学总医院 医学实验中心,银川 750004
Author(s):
BAI Jing; HOU Xing-ning; LAN Hai-qin
Medical Experiment Center, the General Hospital of Ningxia Medical University,Yinchuan 750004,China
关键词:
新生儿;  生物参考区间;  危急值;  凝血功能
分类号:
R446.111
DOI:
10.3969/j.issn.1671-7414.2017.01.042
文献标志码:
A
摘要:
目的 探讨新生儿凝血危急值在临床实践中的应用及正常参考范围的调查,对制定临床诊疗方案以及预防新生儿凝血疾病的应用价值。方法收集2016年1月～6月宁夏医科大学总医院新生儿科凝血标本350例,出生后6 h内检测血浆凝血功能指标(APTT,PT,TT及FIB); 统计和分析所有与新生儿科电话联系后登记的信息完善的危急值病例,调查发生危急值患儿的孕周、出生体重,并分析各危急值项目比例、疾病分布、临床应答情况等。结果 新生儿凝血四项指标与成人及儿童比较以及新生儿早产组与足月组比较差异具有统计学意义(t=1.66～2.66,P均＜0.01); 另外严重患儿及早产/低出生体重儿发生危急值可能性较大,各项危急值分布中APTT高值(32%)和FIB(29%)低值分布最多,新生儿重症肺炎和黄疸是危急值暴发的危险因素; 临床总体应答率占35%,“应答组”和“无应答组”两组患儿颅内/消化道出血确诊率差异无统计学意义(χ2=36.68/39,P＞0.05)。该单位拟制定的新生儿个性化危急值范围为:PT(≤8 s和≥30 s); APTT(≤20 s和≥90 s); FIB(≤0.6 g/L和≥10 g/L)。修改后“应答率”、临床医生重视度均较前有所提高,减少了“假危急值”报告发生率。结论 新生儿凝血指标较成人及儿童均有较大差异,建立适合新生儿凝血参数参考区间及定期对新生儿科凝血危急值临床资料进行总结,有助于制定适合该单位的危急值标准,进而提高临床综合诊疗水平。
Abstract:
Objective To investigate the critical value ofneonatal coagulation and the normal reference range in clinical practice,and make Value of the formulation of clinical treatment programs and prevention of neonatal blood coagulation disorders.Methods Collected neonatal specimens of 350 cases from January to June 2016 in the General Hospital Ningxia Medical University,after birth with in 6h,the parameters of plasma coagulation:activated partial thromboplastin time(APTT),prothrombin time(PT)clotting time(TT)and fibrinogen(FIB).Made statistics and analysis of all critical information to improve the value of the cases after contact with the telephone registration of neonatology,and critical investigation occurred gestational age children value,birth weight,and critical analysis of the proportion of the value of the project,the distribution of the disease,clinical response and so on.Results Compared with adults and children,four indexes of coagulation levels of newborn were significantly different(t=1.66～2.66,P＜0.01),as well as preterm group and term group; additional children with severe and premature birth or low weight occurs critical the possibility of greater value,and the distribution of high APTT and low FIB profile occured in the most critical values,neonatal jaundice and severe pneumonia was a risk factor critical values outbreak.Overall clinical response rate was 33%,the “answer” and “non response group” in children with intracranial hemorrhage of digestive and tract,and the diagnosis rate of statistical results was no significance(χ2=36.68/39,P＞0.05).The range of personal critical value of the newborn infant was intended to develop:PT(≤8 s and ≥30 s),APTT(≤20 s and ≥90 s)and FIB(≤0.6 g/L and ≥10 g/L).Revised “response rate”,clinicians have increased attention compared with the previous increase,reducing the false critical value report incidence.Conclusion The indicators of neonatal coagulation were different from the adults and children.For the establishment of neonatal blood coagulation parameters reference range,on a regular basis to summary on the clinical data of blood coagulation critical value,and contribute to the development of suitable critical value standard,and improve the clinical comprehensive diagnosis and treatment level.

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备注/Memo

备注/Memo:
作者简介:白 静(1988-),检验技师,硕士研究生,研究方向:临床检验诊断学,E-mail:443595621@qq.com。
通讯作者:侯兴宁,副主任技师,E-mail:houxingning@163.com,共同第一作者。
更新日期/Last Update: 2017-01-20