新生儿血小板减少症在新生儿重症监护病房的结局

D. Madhavi, Shamama Subuhi, Mohammed Zubai
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摘要

血小板减少症是新生儿时期最常见的血液系统疾病之一,影响了多达三分之一的新生儿重症监护室患者。众所周知,许多胎儿和新生儿疾病都与血小板减少症有关。大多数新生儿血小板减少症发作相对较轻,自我限制,持续时间短,但由于IVH等严重并发症,可能会导致严重的发病率和死亡率。方法与材料:选择140例新生儿重症监护室三级监护新生儿,了解新生儿血小板减少症的转归和病因。详细的产妇病史和新生儿体格检查,并跟踪新生儿的结果,根据病例进行相关调查。结果:140例新生儿中,63例有血小板减少症(45%),42.8%的新生儿早产,其中63.3%有血小板减少。新生儿血小板减少症的其他危险因素是败血症38(74.5%)、SGA/IUGR 28(80%)和NEC 9(100%)。血小板减少症的母体危险因素是子痫81.8%和妊娠期感染72.72%。95.5%的研究人群出院。4.5%的研究人群没有出院™无法生存。4.54%的轻度、9.09%的中度和60%的重度血小板减少症婴儿没有™无法生存。结论:出血表现,即粘膜、皮肤和颅内出血与严重血小板减少症显著相关。60%的死亡率发生在严重血小板减少组。因此,严重的血小板减少症被发现是新生儿重症监护室患病新生儿预后不佳的预测因素。
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Outcome of neonatal thrombocytopenia in tertiary care NICU
Thrombocytopenia is one of the commonest haematological disorders in the neonatal period, affecting up to a third of those admitted to neonatal intensive care units. It is well recognized that many fetomaternal and neonatal conditions are associated with thrombocytopenia. The majority of episodes of neonatal thrombocytopenia are relatively mild, self-limiting and of short duration but it may cause severe morbidity & mortality due to severe complication like IVH. Methods & material: 140 Newborn admitted in tertiary care NICU were selected to find out outcome and etiology of neonatal thrombocytopenia. Detail maternal history and neonatal physical examination done and Neonates were followed for outcome, relevant investigation done according to cases. Result: Out of 140 neonates 63 neonates had thrombocytopenia (45%).42.8% neonates were premature out of which 63.3% had thrombocytopenia. Other neonatal risk factor for thrombocytopenia are sepsis 38 (74.5%), SGA/IUGR 28(80%) and NEC 9(100%). Maternal risk factor for thrombocytopenia are eclampsia81.8% and infection during pregnancy 72.72%. 95.5 % of all study population were discharged.4.5 % cases of whole study population didn’t survive. 4.54% of mild, 9.09% of moderate and 60 % of severe thrombocytopenic babies didn’t survive. Conclusion: Bleeding manifestations i.e. mucosal, cutaneous and intracranial bleed were significantly associated with severe thrombocytopenia. 60% of mortality was found in severe thrombocytopenic group. Thus, severe thrombocytopenia was found to be a predictor of poor outcome in sick neonates of NICU.
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