RÉSUMÉ
Objective To explore the clinical effect of Salvianolate for treatment of coagulant function abnormality in patients with septic shock.Methods One hundred and fifty-two septic shock patients admitted to Intensive Care Unit (ICU) of Department of Critical Care Medicine,Liuzhou Municipal Liutie Central Hospital from January 2007 to June 2016 were enrolled,and they were divided into a control group (67 cases) and a Salvianolate group (85 cases) by random number table.In the control group,conventional western medicine treatment was given,while in Salvianolate group,besides conventional treatment,additionally,Salvianolate 200 mg intravenous drip was applied daily for consecutive 10 days.The levels of D-dimer and platelet count (PLT) were examined on the 1st,3rd,7th,10th day after admission;disseminated intravascular coagulation (DIC) incidence and mortality were observed in 10 days after admission in the two groups.Results The levels of D-dimer were significantly lower in the Salvianolate group than those of the control group on 3,7,10 days after admission (mg/L:3 days was 9.14 ± 2.25 vs.18.42 ± 3.15,7 days was 6.71 ± 1.49 vs.14.57 ± 1.81,10 days was 1.01-± 0.20 vs.4.79-± 0.81,all P ＜ 0.01).In both groups,on the first day after admission the level of PLT began to decrease,on the 3th,7th day the levels were lowered significantly,and on the 10th day,the level of PLT was elevated;in the Salvianolate group,the levels of PLT were obviously higher on the 3rd,7th,10th day after admission than those of the control group [PLT (x 109/L) 3 days after admission:67.05-± 7.76 vs.40.97 ± 6.51,7 days:67.24 ± 6.35 vs.32.06 ± 5.13,10 days:90.18 ± 11.42 vs.59.04 ± 6.57,all P ＜0.01].The DIC incidence and mortality were significantly lower in the Salvianolate group than those of the control group [DIC incidence:12.94％ (11/85) vs.38.8％ (26/67),mortality:5.88％ (5/85) vs.29.85％ (20/67),both P ＜0.01].Conclusions Coagulant function abnormality was found in most patients with septic shock.The cause of PLT decreasing is mainly due to micro-vascular thrombosis that consumes a lot of PLT.Early intervention with Salvianolate in such patients can inhibit thrombosis,block the exhaustion of PLT and correct the coagulant function abnormality with certain efficacy in the patients.
RÉSUMÉ
Objective To investigate the clinical manifestations and inlfuencing factors in the newborns with coagulant function abnormality in the ifrst 24 hours after birth. Methods The coagulation test results and clinical data of 169 newborns in our hospital were studied. Children receiving anticoagulant therapy were assigned as coagulation abnormalities group (n=76) and other healthy newborns were assigned as control group (n=93). The differences of coagulation function between the two groups were analyzed and the inlfuencing factors of coagulation abnormalities were explored. Results The proportions of fetal distress, pneumonia, acidosis and hypothermia of coagulation abnormalities group were signiifcantly higher than that of the control group (χ2=6.18–38.01, P<0.05). Logistic regression analysis showed that fetal distress (OR=12.06, 95%CI:3.71–39.25), pneumonia (OR=4.10, 95%CI: 1.43–11.74) were the high risk factors for coagulant function abnormality, and the differences were statistically signiifcant (both P<0.05). Conclusions Fetal distress, pneumonia were the high risk factors for coagulant function abnormality. Early prevention can help to reduce the incidence of neonatal hemorrhagic disease.