凝血检验危急值用于重症新生儿病情预测的价值分析

摘要

Objective To study and discuss the clinical value of critical blood coagulation test values on the prognosis of newborns with severe diseases.Methods 200 newborns with severe diseases who were in the pediatric intensive care unit (PICU) of our hospital from January 2011 to December 2015 were selected as observation group, their clinical data and blood coagulation test results were analyzed. The critical blood coagulation test indexes (Fg low value, PT high value, and APTT high value) of the newborns were recorded, the newborns with critical indexes received treatment and the mortality rate was recorded. Another 200 newborns with severe diseases and no blood coagulation tests during January 2005 and December 2010 were selected as control group, the mortality rates of the two groups were compared. Results In the observation group, there were 32 cases (account for 16%) with critical blood coagulation test values, including 18 cases with Fg low values, 5 cases with PT high values, 4 cases with APTT high values, 2 cases with Fg low values and PT high values, 2 cases with Fg low values and APTT high values, and 1 case with PT high value and APTT high value. The mortality rate of the control group was 14%, while that of the observation group was 6%, the difference was statistically significant (P<0.05). The mechanical ventilation time, ICU time, and hospitalization time of the observation group were obviously shorter than those of the control group (P<0.05).ConclusionIn newborns with severe diseases, the critical blood coagulation test values are valuable in predicting the development of diseases, benefitting timely disease follow-up and treatment, improving the prognosis, and decreasing the mortality rate.%目的：研究并探讨凝血检验危急值用于重症新生儿病情预测的临床价值。方法于2011年1月～2015年12月，选取该阶段我院儿科重症监护室收治的200例重症新生儿进行回顾性研究，将其设置为观察组，对其临床资料进行分析，并对其凝血检验结果进行分析，观察凝血检验各项指标的危急值（Fg低值、PT高值、APTT高值）情况，对出现凝血检验危急值的患儿进行救治，统计其死亡率。另选取2005年1月～2010年12月未应用凝血检验危急值的200例重症新生儿进行对比，将其设置为对照组，对比两组患儿的死亡率。结果200例观察组重症新生儿中，有32例患者的凝血检验指标处于危急值状态，所占比例为16%，包括18例Fg低值、5例PT高值、4例APTT高值、2例Fg低值合并PT高值、2例Fg低值合并APTT高值以及1例PT高值合并APTT高值。对照组的死亡率为14%，观察组的死亡率为6%，两组相比，差异具有统计学意义（P＜0.05）。观察组患儿的机械通气时间、PICU监护时间以及住院时间均明显短于对照组（P＜0.05）。结论在重症新生儿中，应用凝血检验危急值可有效预测病情的发展，有利于及时追踪病情，并及时给予患儿救治，可有效改善预后，减少死亡。