超微剂量肝素早期治疗新生儿脓毒症的疗效探讨

目的:评估微量肝素早期治疗新生儿脓毒症的效果和对病情转归的影响。方法:对诊断符合标准的95例新生儿脓毒症患儿随机分组进行前瞻性对照研究,对照组47例,给予抗感染、保护重要脏器功能等常规治疗;治疗组48例,在常规治疗基础上早期皮下注射肝素每次3-5U/kg,6h一次,共用3d。结果:与治疗前相比,治疗组在经肝素治疗后凝血功能(PT、APTT、Fbg、D-D、TT)显著改善,血小板计数(PLT)显著升高。治疗后,治疗组的APTT、TT、D-D与对照组的差异无统计学意义。但两组PT、Fbg、PLT有显著差异,治疗组与对照组3项指标比较分别为:(13.45±2.62)s比(15.18±4.96)s,(2.67±0.95)g/L比(1.96±0.83)g/L,(130.46±39.22)×109/L比(95.61±10.33)×109/L,P<0.05。治疗组全身炎症反应综合征(SIRS)持续时间缩短,严重脓毒症发生率下降(10/48比19/47),与对照组相比有统计学意义(P<0.05)。结论:超微剂量肝素早期治疗新生儿脓毒症,可有效改善患儿凝血功能,缩短SIRS持续时间,降低严重脓毒症发生率。

Efficiency of Early Treatment for Neonatal Sepsis of Ultramicro-Dose Heparin

Objective:To evaluate the effectiveness of the early treatment of neonatal sepsis by ultrami-cro-dose heparin and its short-term outcomes.Methods:Ninety-five cases of neonatal sepsis were randomly divided into control group for conventional treatment(n=47)and ultramicro-dose heparin treatment group(n=48)for conventional treatment plus early subcutaneous injection of heparin 3-5U/kg every 6hours for 3 days.Results:The blood coagulation indices,including PT, APTT,Fbg,D-D,and TT,and blood platelet count(PLT)in heparin treatment group significantly improved after heparin treatment.The coagulation indices such as APTT,TT,and D-D had no difference between heparin treatment goup and control group,but PT,Fbg,and PLT showed significant difference as(13.45±2.62)s vs(15.18±4.96)s,(2.67±0.95)g/L vs (1.96±0.83)g/L,and(130.46±39.22)109/L vs(95.61±10.33)109/L respectively(all P<0.05).Compared with the control group,the persistent period of systemic inflammatory response syndrome(SIRS)in heparin treatment group was shortened,and the incidence of severe sepsis was decreased(10/48 vs 19/47)(both P<0.05).Conclusion:Early treatment for neonatal sepsis by ultramicro-dose heparin could safely and significantly improve the blood coagulation fuctions and shorten the persistent period of SIRS,also decrease the incidence of severe sepsis.