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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。
Objective: To evaluate the effect of micro-heparin in the early treatment of neonatal sepsis and its effect on the prognosis of the disease. Methods: Ninety-five neonates with sepsis who had been diagnosed as eligible were randomly divided into two groups: control group (n = 47), anti-infection and protection of vital organs function On the basis of early subcutaneous injection of heparin 3-5U / kg, 6h once, sharing 3d. Results: Compared with those before treatment, the coagulation function (PT, APTT, Fbg, D-D, TT) in the treatment group was significantly improved and the platelet count (PLT) was significantly higher than that before treatment. After treatment, the treatment group APTT, TT, D-D and the control group, the difference was not statistically significant. There were significant differences in PT, Fbg and PLT between the two groups (13.45 ± 2.62 s vs 15.18 ± 4.96 s and (2.67 ± 0.95) g / L vs 1.96 ± 0.83) g / L, (130.46 ± 39.22) × 109 / L (95.61 ± 10.33) × 109 / L, P <0.05. The duration of systemic inflammatory response syndrome (SIRS) was shortened and the incidence of severe sepsis was decreased in the treatment group (10/48 vs 19/47), which was significantly higher than that in the control group (P <0.05). Conclusion: The early treatment of neonatal sepsis with ultra-low dose heparin can effectively improve the coagulation function, shorten the duration of SIRS and reduce the incidence of severe sepsis.