持续静滴小剂量肝素治疗新生儿弥散性血管内凝血的临床研究

目的探讨持续静滴小剂量肝素在弥散性血管内凝血中的疗效和安全性。方法对诊断明确的弥散性血管内凝血的患儿双盲、随机分为治疗Ⅰ组（31例）、Ⅱ组（36例）,两组皆建立专用通道。治疗Ⅰ组给予肝素每次62.5～125 u/kg,每4～6小时一次;治疗Ⅱ组给予持续静滴小剂量肝素每24小时60～90 u/kg,其他治疗两组相同。根据病情每日或隔日复查血常规、网织红细胞、凝血系统、3P试验和D-二聚体以指导治疗,为防止肝素所致的出血,及时加用鱼精蛋白。结果两组在住院时间（天）、肝素应用时间（天）、PC恢复时间、D-二聚体恢复时间、治愈（率%）和死亡（率%）比较,治疗Ⅱ组明显优于治疗Ⅰ组,经t检验,P〈0.001,差异显著。结论持续静滴小剂量肝素在弥散性血管内凝血中疗效肯定,有较高的安全性。

The clinical study of low - dose heparin with continous intravenous drip infusion in disseminated intravascular coagulation of newborn

Objective: To investigate the efficiency and safety of low-dose heparin with continous intravenous drip infusion in the treatment of disseminated intravascular coagulation(DIC).Methods: In this randomized prospective double-blind trial,77 children diagnosed as DIC were assigned into the therapy-group 1(n=31)and the therapy-group 2(n=36).The special vein was prepared for them.Patients in the first group receive heparin with 62.5~125 U /kg once per4-6hr and patients in the second group receive 60~90U/kg in 24h with continous intravenous drip infusion,other treatments were similar in two groups.According to the patients' condition,hemogram,reticulocytes,blood coagulation,plasma protamine paracoagulation and D-dimer were detected to guide the clinical therapy,rotamine was used to prevent bleeding tendency.Results:The hospital day,the day of using heparin,the recovery of blood platelet and D-dimer,cure rate and death rate in the group of low-dose heparin with continous intravenous drip infusion are all significantly superior to those in the first group(P<0.001).Conclusion:These results suggest that heparin in a relatively small dosage by continous intravenous drip infusion can improve DIC efficiently and have great security.