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[儿童败血症中的消耗性凝血病与单纯性血小板缺乏症]

[Consumption coagulopathy and isolated platelet deficiency in childhood septicaemia].

作者信息

Mitterstieler G, Waltl H, Kurz R

出版信息

Dtsch Med Wochenschr. 1975 Feb 21;100(8):342-6, 351-5. doi: 10.1055/s-0028-1106218.

Abstract

In a retrospective study 40 children were selected out of 53 cases of septicaemia with thrombocytopenia. They were divided into two coincidentally equally large groups of patients with consumption coagulopathy on the one side and patients with isolated thrombocytopenia without consumption coagulopathy on the other side. Both groups were of comparable age and sex distribution. Two-thirds of the children were under three months. For the differential diagnosis of both groups the activated partial thromboplastin time, the thrombotest, the factor V plasma concentration, the serum concentration of fibrin (fibrinogen) degradation products as well as control coagulation studies can be considered to have the greatest diagnostic value. The results of the study permit the following conclusions: 1. Platelet deficiency in sepsis does not prove the presence of consumption coagulopathy. 2. Consumption coagulopathy and isolated thrombocytopenia differ statistically significantly according to the bacteria cultured from the blood, the circulatory state and the pH of the blood. 3. The finding of thrombocytopenia in a patient with shock, acidosis and gramnegative septicaemia justify the suspicion of consumption coagulopathy.

摘要

在一项回顾性研究中,从53例伴有血小板减少的败血症患儿中选取了40例。他们被偶然分为两组,每组人数相等,一组为消耗性凝血病患者,另一组为无消耗性凝血病的单纯血小板减少患者。两组患者的年龄和性别分布具有可比性。三分之二的儿童年龄在三个月以下。对于两组的鉴别诊断,活化部分凝血活酶时间、凝血酶试验、因子V血浆浓度、纤维蛋白(纤维蛋白原)降解产物的血清浓度以及对照凝血研究被认为具有最大的诊断价值。研究结果可得出以下结论:1. 败血症中的血小板缺乏并不能证明存在消耗性凝血病。2. 根据血液培养出的细菌、循环状态和血液pH值,消耗性凝血病和单纯血小板减少在统计学上有显著差异。3. 在休克、酸中毒和革兰氏阴性败血症患者中发现血小板减少,应怀疑存在消耗性凝血病。

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