Analysis Of Coagulationg Functiong Status And Clinical Intervention In Premature Infants

Objective : Retrospective analysis of premature infants admitted to our hospital from August 2016 to July 2018,to explore the coagulation status of premature infants,and to analyze the efficacy of premature infants with infusion plasma and cryoprecipitate.The factors affecting coagulation function in preterm infants provide a clinical reference for further understanding and standardization of coagulation dysfunction and prognosis in preterm infants.Methods:The data of premature infants,who born in the First Affiliated Hospital of Guangxi Medical University and hospitalized in the neonatal department and NICU from August 2016 to July 2018 were recruited and analyzed.Firstly,according to whether or not to give plasma and cryoprecipitate,we were divided into the intervention group and the non-intervention group.Then he untreated group was divided into hemorrhagic group and non-bleeding group according to whether there was bleeding.Analysis of non-bleeding grouppreterm infants in each gestational age group within 2h,2 ~ 7d,8 ~ 14 d coagulation Functional status,the factors influencing coagulation function,and treatment effects in the intervention group.Results1.A total of 409 patients were included in the study between August 2016 and July 2018,22(5.4%)in the intervention group and 387(94.6%)in the un-intervention group.In the intervention group,14 patients(63.6%)had early preterm infants,4(18.2%)had mid-term premature infants,4(18.2%)had advanced preterm infants,and 19 patients received fresh frozen plasma,of which 13 were early preterm infants.There were 3 cases of cryoprecipitate infusion and 2 cases of early preterm infants.In the non-intervention group,20patients(5.2%)had early preterm infants,55(14.2%)had mid-term premature infants,and 312(80.6%)had late preterm infants.2.409 cases in the present study,91(22.2%)developed bleeding during hospitalization,including 79 cases of intracranial hemorrhage(86.8% of bleeding cases),3 cases of gastrointestinal bleeding(3.3% of bleeding cases),pulmonary hemorrhage 1 case(1.1% of bleeding cases),skin and mucous membrane bleeding in 5 cases(5.5% of bleeding cases),intracranial hemorrhage with gastrointestinal bleeding in 2 cases(2.2% of bleeding cases),pulmonary hemorrhage with skin and mucous membrane bleeding in 1 case(1.1% of bleeding cases).11 of them were given clinical intervention.Of the 79 cases of intracranial hemorrhage,75 cases(93.7%)had periventricular hemorrhage,1case(1.3%)of subdural hemorrhage,and 3 cases(3.7%)of parenchymal hemorrhage.Among 75 patients with periventricular-intraventricular hemorrhage,there were 27 cases(36%)with intraventricular hemorrhage,45cases(60%)with intraventricular hemorrhage,and 3 cases(4%)with intraventricular hemorrhage.3.Among the 307 premature infants without hemorrhage,the PT,APTT,and TT times were shortened with the increase of age in the coagulation function indexes within 2 hours,2nd to 7th,and 8th to 14 th day after birth.FIB and PLT were daily.The age is increasing and the difference between APTT,TT and PLT is significant among the three groups(P< 0.01).4.Within 5 days after infusion of plasma or cryoprecipitate,the mean values of PT,APTT and TT were all lower than before infusion,FIB was higher than before infusion,and PLT showed no significantly changed.Among the three cases of premature infants with cryoprecipitate before and after infusion,the comparison of FIB between the two groups was statistically significant(P<0.05),while the comparison of PT,APTT,TT and PLT between the two groups was not statistically significant(P>0.05).There were 19 cases of preterm infants with fresh frozen plasma infusion,and the comparison of PT between the two groups before and after plasma infusion was statistically significant(P<0.05),while the comparison of APTT,FIB,TT and PLT was not statistically significant(P > 0.05).Conclusions1.The coagulation function of premature infants is related to gestational age and age.The smaller the gestational age,the more immature the coagulation function develops.After birth,the coagulation system develops further with the increase of age.In addition,the coagulation function is also related to body weight,mode of delivery,and mother.Pregnancy-induced hypertension syndrome,maternal pregnancy with diabetes.2.Coagulation function indicators do not reflect bleeding,and some children with normal coagulation function may also have bleeding.In hemorrhagic diseases of premature infants,intracranial hemorrhage is the main manifestation,and the smaller the gestational age,the higher the incidence.3.Infusion of fresh frozen plasma and cryoprecipitate can improve partial coagulation parameters and bleeding performance in children with bleeding,and some of the premature infants used for prevention but no clinical bleeding are still unclear.