新生儿发生血小板减少的频率和结果——一项前瞻性观察性研究

Sarbari Saha, D. Roy, I. Jahan, Mohammad Kamrul Hassan Shabuj, Sadeka Choudhury, M. Mannan, M. Shahidullah, S. Dey
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引用次数: 0

摘要

血小板减少症是新生儿重症监护病房(NICU)最常见的血液学异常。这项前瞻性观察性研究于2016年9月至2017年8月在达卡Bangabandhu Sheikh Mujib医科大学(BSMMU) NICU连续收治的78名高危新生儿中进行。在入组时测量所有高危新生儿的血小板计数,小于15万/cmm被认为是确定血小板减少症的分界点。每隔一天测量一次血小板计数,直到出院或如果初始血小板计数低血小板计数恢复正常。如果最初的血小板计数显示正常,那么如果婴儿进一步发展为血小板减少症的危险条件,则进行临床随访。从入组到出院期间,如果任何婴儿在任何时间出现血小板减少症,则该婴儿被定义为血小板减少症。78名高危新生儿中39.7%的患者发现血小板减少。妊高征(PIH)、新生儿脓毒症和小胎龄(SGA)、宫内生长受限(IUGR)、早产、坏死性小肠结肠炎(NEC)与血小板减少症显著相关。脓毒症和NEC是血小板减少症的独立危险因素。关于结果,血小板减少患者的住院时间明显多于非血小板减少患者。血小板减少患者的死亡率也高于非血小板减少患者。Bsmmu j 2022;15 (2): 115 - 120
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Frequency and outcome of thrombocytopenia in neonates who are at risk of developing thrombocytopenia - a prospective observational study
Thrombocytopenia is the commonest hematological abnormality encountered in the neonatal intensive care unit (NICU). This prospective, observational study was conducted among 78 consecutive at-risk neonates admitted in NICU, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from September 2016 to August 2017. Platelet count was measured in all at risk neonates at enrollment and less than 1,50,000/cmm was consiered as the cut off point for determining thrombocytopenia. Platelet count was measured every alternate day till discharge or normalisation of platelet count if the initial platelet count was low. If initial platelet count revealed normal, then the babies were followed up clinically if they develop any further risk condition for developing thrombocytopenia. During the period from enrollment to discharge, if any baby develops thrombocytopenia at any time then baby was defined as thrombocytopenic. Overall 39.7%patients found to be thrombocytopenic among 78 at-risk neonates. Pregnancy induced hypertension (PIH), neonatal sepsis and small for gestational age (SGA), intra uterine growth restriction(IUGR), prematurity, necrotizing enterocolitis (NEC) were significantly associated with thrombocytopenia. Sepsis and NEC were found to be independent risk factor for thrombocytopenia. Regarding outcome, length of hospital stay was significantly more in thrombocytopenic patients than non-thrombocytopenic patients. Death rate was also higher in thrombocytopenic patients in comparison to non-thrombocytopenic patients. BSMMU J 2022; 15(2): 115-120
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