潘粟 张媛昊

[摘要] 目的 探讨晚发性维生素K缺乏性颅内出血的病因、治疗方法及预防措施。 方法 对笔者所在医院收治的31例晚发性维生素K缺乏性患儿进行分析。其中纯母乳喂养25例、腹泻病史15例、抗生素使用史14例。分别予静脉注射维生素K1及止惊、降颅压、输血对症支持治疗。 结果 治愈24 例，死亡2例。 结论 对于本病要早诊断、早治疗，而做好预防工作是提高治愈率、减少病死率和致残率的关键。建议产科予新生儿预防性肌注维生素K1，对于3 个月以内的单纯母乳喂养儿，在合并长期腹泻、黄疸延迟、应用抗生素、存在吸收障碍时均应补充维生素K。

[关键词] 婴幼儿；维生素K缺乏症；晚发性

[中图分类号] R723.2???[文献标识码] B???[文章编号] 2095-0616（2012）15-182-02

Analysis on 31 cases of infant late onset vitamin K deficiency

PAN?Su1??ZHANG?Yuanhao2

1.Department of Pediatrician,the Second People's Hospital of Guizhou Province,Guiyang 550018,China; 2.Department of Pediatrician,People's Hospital of Anshun City,Anshun 561000,China

[Abstract] Objective To analyze the cause of infantile late vitamin K deficiency and to raise preventive and therapeutic measures. Methods An analysis for the 31 cases diagnosed as infantile late vitamin deficiency in our hospital,among which 25 were exclusively breast feeding,15 were registered with a history of diarrhea and 14 used antibiotics before.They were all symptomatic treated and took vitamin K1 preparation.Supportive measures such as lowering intracranial preseure and blood transfusion. Results 24 cases were healed and 2 dead. Conclusion Early diagnose and treatments are the key to the complete recovery of the disease while prevention is also of vitla importance.Preventive intramuscular injection of vitamin K1 is suggested to be given to newborn infants.For infants within 3 months'old,supplement of vitamin K1 is suggested when malabsorption occurs.

[Key words] Infant;Vitamin K deficiency;Late onset

维生素K缺乏性出血症也称获得性凝血酶原缺乏症，是由于维生素K的摄入和吸收不足或因肝功能障碍不能利用维生素K合成凝血酶原所引起的出血症，发生于出生后2周～3个月。婴儿维生素K缺乏性出血症称晚发型维生素K缺乏性出血症，临床上常与感染性疾病、营养不良及用药有一定关系，笔者所在医院自2005年3月～2007年2月收治该病患儿31 例，现报道如下。

1?资料与方法

1.1?一般资料

本组31例晚发性维生素K缺乏症患儿，男22例，女9例；年龄14～90 d，其中14～30 d 3例，31～60 d 22例，61～90 d 6例。发病到入院时间12 h～3 d 25例，3 d以上6例。单纯母乳喂养25例，混合喂养6例。所有患儿无产伤、窒息及家族出血性病史。均未接受过维生素K预防注射。

1.2临床表现

穿刺点出血不止28例，肠道出血7例，皮肤黏膜出血8例。颅内出血15例，前卤饱满11例，凝视14例，抽搐12例，脑疝4例。……