Kiselova M
Danylo Halytsky Lviv National Medical University, Department of Pediatrics and Neonatology of the Faculty of Postgraduate Education, Lviv, Ukraine.
Georgian Med News. 2019 Feb(287):45-50.
In the article intended for neonatologists, general practitioners and family doctors, the main causes of hemostatic disorders that lead to the development of hemorrhagic syndrome in newborns and infants are given. The emphasis is on the different forms of neonatal hemorrhagic disease (HD), which is based on the deficiency of vitamin K1, and therefore the bleeding that is observed in children who are breastfed in the first half of life is mostly associated, namely, with vitamin K deficiency. Risk factors of HD depending from the time of the beginning, of the action of one or another factor. The main clinical manifestations of both early and late forms of HD are described, it is shown which of them are mistakenly diagnosed that lead to the appointment of the wrong treatment. The assessment of the need for prevention of late form of bleeding associated with vitamin K deficiency is carried out by determining the concentration in the blood of a functional coagulation marker - PIVKA II. Modern methods of prevention of late bleeding associated with vitamin K1 deficiency, based on nosological units - chronic cholestasis, cystic fibrosis, are presented. The current recommendations on the use of vitamin K1 in newborns and infants of the American Academy of Pediatrics, the scientific community of Canada, Netherlands, Switzerland, Germany, France, the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), the World Health Organization, which are clearly followed by the effects of local peculiarities are described and interpreted. on approaches to the prevention of bleeding associated with vitamin K1 deficiency, which affects the choice of a single dose, the duration of the prophylactic course and the route of administration of vitamin in K1 (phytomenadion). The role of parents in the prevention of vitamin K deficiency is emphasized.
在这篇面向新生儿科医生、全科医生和家庭医生的文章中，给出了导致新生儿和婴儿出血综合征发生的止血障碍的主要原因。重点是新生儿出血性疾病（HD）的不同形式，其基于维生素K1缺乏，因此在生命上半年进行母乳喂养的儿童中观察到的出血大多与之相关，即与维生素K缺乏有关。根据一个或另一个因素作用开始的时间，阐述了HD的危险因素。描述了HD早期和晚期形式的主要临床表现，指出其中哪些被误诊，从而导致错误的治疗。通过测定功能性凝血标志物——异常凝血酶原II在血液中的浓度，对预防与维生素K缺乏相关的晚期出血的必要性进行评估。介绍了基于疾病单元——慢性胆汁淤积、囊性纤维化，预防与维生素K1缺乏相关的晚期出血的现代方法。描述并解释了美国儿科学会、加拿大科学界、荷兰、瑞士、德国、法国、欧洲儿科胃肠病学、肝病学和营养学会（ESPGHAN）、世界卫生组织关于新生儿和婴儿使用维生素K1的当前建议，这些建议明显受到当地特点的影响。阐述了预防与维生素K1缺乏相关出血的方法，这些方法影响单次剂量的选择、预防疗程的持续时间以及维生素K1（植物甲萘醌）的给药途径。强调了父母在预防维生素K缺乏中的作用。
