Jonville-Bera A P, Autret E
Department of Clinical Pharmacology, Hôpital Bretonneau, Tours, France.
Eur J Clin Pharmacol. 1997;52(5):333-7. doi: 10.1007/s002280050297.
Because of the risk of haemorrhagic disease of the newborn as a result of a deficit in vitamin K, it is generally agreed that newborns should receive vitamin K. However, there is no consensus concerning the route of administration, dose, number of doses, or dose frequency.
We studied patterns of vitamin K administration in all maternity hospitals in France in order to establish the range of practices and policies. Six hundred and forty questionnaires were analysed. Vitamin K was given systematically to all neonates in 619 maternity hospitals (96.7%), not given to any neonates in 2 (0.3%), and only to certain newborns in 19 (3%). A similar protocol was used for all newborns in 299 (47%) of the maternity hospitals, and the treatment protocol differed according to the neonatal clinical picture in 336 maternity hospitals (53%).
The route of administration agreed with the recommendation that healthy newborns receive formula milk. In contrast, infants receiving breast milk were given IM vitamin K in only 19% of the maternity hospitals studied and regular weekly doses were prescribed in only 56%. In premature infants, IM doses were prescribed in only 46% of cases and repeat weekly doses in 34%. The dose generally prescribed (5 mg p.o. or IM) was not the recommended dose.
由于维生素K缺乏导致新生儿出血性疾病的风险,普遍认为新生儿应接受维生素K。然而,在给药途径、剂量、剂量次数或给药频率方面尚无共识。
我们研究了法国所有产科医院的维生素K给药模式,以确定实践和政策的范围。分析了640份问卷。在619家产科医院(96.7%)中,所有新生儿都系统地接受了维生素K,2家医院(0.3%)没有给任何新生儿使用,19家医院(3%)仅给某些新生儿使用。299家(47%)产科医院对所有新生儿采用了类似的方案,336家产科医院(53%)的治疗方案根据新生儿临床表现有所不同。
给药途径与健康新生儿接受配方奶的建议一致。相比之下,在所研究的产科医院中,仅19%给接受母乳的婴儿肌肉注射维生素K,仅56%规定每周定期给药。在早产儿中,仅46%的病例采用肌肉注射给药,34%重复每周给药。通常规定的剂量(口服或肌肉注射5毫克)并非推荐剂量。