Cekinmez Melih, Cemil Tuba, Cekinmez Eren Kale, Altinörs Nur
Department of Neurosurgery, Faculty of Medicine, Baskent University, Dadaloglu Mahallesi, 01250, Yuregir, Adana, Turkey.
Childs Nerv Syst. 2008 Jul;24(7):821-5. doi: 10.1007/s00381-007-0537-9. Epub 2007 Nov 29.
Vitamin K deficiency bleeding (VKDB) represents a clinical picture characterized by bleedings due to insufficient levels of vitamin-K-dependent hemostatic factors. VKDB can be classified into three groups as early, classic, and late according to time of occurrence. Late-type VKDB has particular importance due to frequent intracranial hemorrhages that lead to high mortality and morbidity. In our study, we aimed to emphasize the importance of vitamin K prophylaxis in prevention of late-type VKDB.
Data of 12 infants treated for intracranial hemorrhage due to late-type VKDB in Baskent University Hospitals between June 1998 and June 2005 have been analyzed.
The ages of patients ranged between 25 and 90 days. Five were born in the hospital and seven were born at home. None of the infants born at home received vitamin K prophylaxis. Hemorrhages were classified as intraparenchymal in 58.33%, subarachnoid in 50.00%, subdural in 50.00%, intraventricular in 41.66%, and epidural in 8.33% according to cranial computerized tomography findings. Surgery was performed in seven cases (58.33%). A total of six patients died (50.00%). Three of the deaths were from the surgery-performed group.
All newborns should receive vitamin K prophylaxis to prevent bleeding due to vitamin K deficiency. Symptoms of any predisposing disease and warning bleeds must be noticed early and additional doses of vitamin K should be administered, if required.
维生素K缺乏性出血(VKDB)是一种临床病症,其特征为因维生素K依赖的止血因子水平不足而导致出血。根据发生时间,VKDB可分为早发型、经典型和晚发型三组。晚发型VKDB尤为重要,因为频繁发生的颅内出血会导致高死亡率和高发病率。在我们的研究中,我们旨在强调维生素K预防在预防晚发型VKDB中的重要性。
分析了1998年6月至2005年6月间在巴斯肯特大学医院因晚发型VKDB接受颅内出血治疗的12例婴儿的数据。
患者年龄在25至90天之间。5例在医院出生,7例在家中出生。在家中出生的婴儿均未接受维生素K预防。根据头颅计算机断层扫描结果,出血分类为脑实质内出血占58.33%,蛛网膜下腔出血占50.00%,硬膜下出血占50.00%,脑室内出血占41.66%,硬膜外出血占8.33%。7例(58.33%)进行了手术。共有6例患者死亡(50.00%)。其中3例死亡来自接受手术的组。
所有新生儿均应接受维生素K预防,以预防维生素K缺乏导致的出血。必须尽早注意任何易感疾病的症状和警示性出血,如有需要,应额外给予维生素K剂量。