Schepers G P, Dimitry A R, Eckhauser F E, Kirking D M
Department of Pharmacy, Veterans Administration Medical Center, Ann Arbor, MI 48105.
JPEN J Parenter Enteral Nutr. 1988 Mar-Apr;12(2):174-7. doi: 10.1177/0148607188012002174.
Efficacy and safety of intravenous and intramuscular vitamin K were compared prospectively in patients receiving total parenteral nutrition. Sixty patients randomly received either a 1-mg daily iv injection (iv group) or a 10-mg weekly injection group (im group). Efficacy was determined by the prolongation of twice-weekly prothrombin (PT) and activated partial thromboplastin (APTT) times. The prolongation of both was not significantly different between the im and iv groups. The percent of PTs outside the normal range was not different for the two groups, although the iv group had more APTT values outside the range than did the im group (p = 0.002). The number of adverse reactions reported in the iv (5) and im (4) groups was also similar. Reactions were minor, not reproducible, and all patients recovered without sequelae. PT results from the iv and im groups were combined and compared to values from 28 patients in an earlier study who did not receive vitamin K. PTs in the no-vitamin K group were significantly prolonged over the vitamin K group (p = 0.0004). The results confirm that regular addition of vitamin K to TPN regimens decreases the incidence of elevated PTs. When administered appropriately, iv and im administration of vitamin K appear to be equally safe and effective in maintaining normal PTs and APTTs.
对接受全胃肠外营养的患者前瞻性地比较了静脉注射和肌肉注射维生素K的疗效和安全性。60例患者随机接受每日1毫克静脉注射（静脉注射组）或每周10毫克注射（肌肉注射组）。通过每周两次的凝血酶原（PT）和活化部分凝血活酶（APTT）时间延长来确定疗效。肌肉注射组和静脉注射组两者的延长情况无显著差异。两组超出正常范围的PT百分比无差异，尽管静脉注射组超出范围的APTT值比肌肉注射组更多（p = 0.002）。静脉注射组（5例）和肌肉注射组（4例）报告的不良反应数量也相似。反应轻微，不可重复，所有患者均康复且无后遗症。将静脉注射组和肌肉注射组的PT结果合并，并与早期一项未接受维生素K的28例患者的值进行比较。无维生素K组的PT显著长于维生素K组（p = 0.0004）。结果证实，在全胃肠外营养方案中定期添加维生素K可降低PT升高的发生率。当适当给药时，静脉注射和肌肉注射维生素K在维持正常PT和APTT方面似乎同样安全有效。
