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发展中国家某教学医院收治的未矫正先天性心脏缺陷患儿的凝血异常。

Coagulation abnormalities in children with uncorrected congenital heart defects seen at a teaching hospital in a developing country.

机构信息

Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria.

Department of Paediatrics, Massey Street Children's Hospital, Lagos Island, Lagos, Nigeria.

出版信息

PLoS One. 2022 Jul 28;17(7):e0263948. doi: 10.1371/journal.pone.0263948. eCollection 2022.

Abstract

BACKGROUND

Coagulation abnormality is a significant complication and cause of mortality in children with uncorrected congenital heart defects (CHD). The aim of this study was to determine the prevalence of coagulation abnormalities and the associated factors in children with uncorrected CHD.

METHOD

A cross sectional study conducted to determine the prevalence of coagulation abnormalities among 70 children with uncorrected CHD aged six months to 17 years and 70 age and sex matched apparently healthy controls. Coagulation abnormalities was determined using complete blood count, prothrombin time, activated partial thromboplastin time and D-dimer assay.

RESULTS

The prevalence of coagulation abnormalities among children with CHD and controls was 37.1% and 7.1% respectively. Children with Cyanotic CHD had a significantly higher prevalence of coagulation abnormalities compared to children with Acyanotic CHD (57.1% versus 17.1%). Haematocrit and oxygen saturation levels were significantly associated with coagulation abnormalities.

CONCLUSION

This study affirms that coagulation abnormalities are frequent in children with uncorrected CHD. Oxygen saturation and haematocrit are risk factors of coagulation abnormalities. Routine coagulation screen is recommended especially in children with cyanotic congenital heart defects to improve their quality of life and reduce morbidity and mortality while awaiting definitive surgeries.

摘要

背景

凝血异常是未经矫正的先天性心脏病(CHD)儿童的一种严重并发症和死亡原因。本研究旨在确定未经矫正的 CHD 儿童凝血异常的发生率及相关因素。

方法

采用横断面研究方法,对 70 例年龄在 6 个月至 17 岁的未经矫正的 CHD 儿童和 70 例年龄和性别匹配的健康对照者进行凝血异常的发生率。采用全血细胞计数、凝血酶原时间、活化部分凝血活酶时间和 D-二聚体测定来确定凝血异常。

结果

CHD 患儿和对照组凝血异常的发生率分别为 37.1%和 7.1%。紫绀型 CHD 患儿的凝血异常发生率明显高于非紫绀型 CHD 患儿(57.1%比 17.1%)。血细胞比容和氧饱和度与凝血异常明显相关。

结论

本研究证实未经矫正的 CHD 儿童凝血异常较为常见。氧饱和度和血细胞比容是凝血异常的危险因素。建议对有紫绀性先天性心脏病的儿童进行常规凝血筛查,以提高其生活质量,降低发病率和死亡率,同时等待确定性手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ed7/9333323/fc817776d8cc/pone.0263948.g001.jpg

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