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Thrombotest에 依한 新生兒出血症과 그 豫防에 對한 觀察

Thrombotest for Coagulation Studies in the Newborn and Vitamin K Prophylaxis

소아과 1965년 8권 2호 p.1 ~ 8
김길영, Courtland, Robinson J., 고극훈, 이종무,
소속 상세정보
김길영 (  ) - 연세대학교 의과대학 소아과학교실
 ( Courtland, Robinson J. ) - 연세대학교 의과대학 산부인과학교실
고극훈 (  ) - 연세대학교 의과대학 소아과학교실
이종무 (  ) - 연세대학교 의과대학 임상병리학교실

Abstract


Hemorrhagic disorder of the newborn infant was fist described in 1894 by Dr. Townsend. Since then the etiology, therapy and prophylaxis pave aroused great interest.
The object of the present work has been to investigate the risk of hemorrhage in newborn infants and the possible need for vitamin K prophylaxis.
In the newborn period, numerous investigators were able to demonstrate a temporary depression of the coagulation factors, which include prothrombin, proconvertin, plasma thromboplastin component and Stuart-Prower factor.
The thrombotest, which detects the reduction of the four factors mentioned above, was utilized to determine the coagulability of the blood of newborn babies who recivied a vitamin K preparation.
According to this method, a risk of hemorrhage is believed to occur when the thrombotest percentage (T.T%) is below 10.
We have used "Menadione Sodium Bisulfite" from the Vitami K preparations. because it is !Huth less expensive and used widely in general clinic.
One hundred and forty four healthy full-term new-borns and fourteen premature babies have been investigated.
The subj:cts were divider into 6 groups;
Group 1. consisted of =5 newborn infants who did not
receive vitamin K after birth. (Fig 4) Group 11. consisted of 34 newborn infants who received
2 mg of Menadione sodium Bisulfite intra-
muscularly immediately after birth_ (Fig 5) Group 111. consisted of 35 infants whose mothers had
received 10 mg of Menadione scdiLin bisulfite intramuscularly 4 to 24 hours before de-livery. (Fig 6)
Group IV. consisted of 15 infants who received 5 mg oral INlenadione sodium bisulfite immediately after birth. (Fig7)
Group V. consisted of 15 infants whose mothers had received 20 mg oral Menadione sodium bisu--lfite 4 to 24 hours before delivery. (Fig 8)
Group VI. consisted of 14 premature babies who did not received Vitamin K after birth. Their weights were between 1780 gm to 2500 gm. (Fig 9)
Using a new method of Thrombotest, we found in these groups that coagulation defect on 2 nd and 3 rd day of life is so great as to constitute a risk of hem orrhage.
These phencmer_a could be prevented in groups of administering M-cadione sodium bisulfite (Vit. K3) (Group 11, ill, IV & V), especially to the mother 4 to 24 hours prior to delivery, either orally or intramuscularly. (Group I1 i& V)
In premature group, the majority averaged TT% are low to ccrr pare with control group.
The risk of Jaundice in the newborn infants who received Vit. K-, cr whese mothers had received Vit. K;, was also investigatcd, and showed that a single dose of Menadione sodium bisulfite did not cause hyperbilirubinemia. (Table 1)
From the above findings, it is concluded that Vita-min K prophylaxis is repuired by all newborn Eabies in order to prevent_ hemorrhagic disorders during the 2 nd and rd day of life.

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