大量的脑内出血在维生素K预防的设置中,拒绝预防
Sima Vazquez1, Emirose Thattil1, Heather J McCrea2,3
1Department of Neurological Surgery, University of Miami Miller School of Medicine/Jackson Health System, Miami, FL, USA.
概括
新生儿在出生时没有接受维生素K预防的风险是严重的内出血. 迅速扭转凝血病和手术干预对于管理这种危及生命的疾病至关重要.
科学领域:
- 新生儿医学 新生儿医学
- 儿科神经学 儿科神经学
- 血液学 血液学 血液学
背景情况:
- 维生素K对于新生儿的凝血因子合成至关重要.
- 维生素K缺乏症出血 (VKDB) 可以导致严重出血,包括内出血 (ICH).
- 新生儿拒绝维生素K预防的情况正在增加.
研究的目的:
- 介绍一个2个月大的婴儿因缺乏维生素K而患有ICH的病例.
- 突出重症新生儿ICH的关键管理步骤.
- 为了强调维生素K预防的重要性.
主要方法:
- 一个2个月大的婴儿出现ICH的案例报告.
- 诊断工作包括CT扫描和凝血研究 (INR,PTT,TEG).
- 治疗包括维生素K的注射,积极的输血,PICU监测和解压性脑膜切除术.
主要成果:
- 该患者出现了大ICH,中线转移和严重的凝血病 (INR>15,PTT>200,TEG>69).
- 凝血病的成功逆转允许进行解压性手术.
- 患者从ICH和TRALI中恢复过来,在6个月的随访中神经学结果良好.
结论:
- 没有接受维生素K预防的婴儿有感染ICH的风险.
- 在ICH手术之前,逆转凝血病至关重要.
- 多学科的团队合作对于管理严重的新生儿ICH至关重要.
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