Haemorrhagic disease of the newborn due to vitamin K deficiency. certain body of vitamin K-dependent coagulation factors and lower vitality bleeding caused by self-limited disease. Since the beginning of the 20th century to the 1960s, after the birth of conventional injection of vitamin K1, the disease has been rare.

[Etiology and pathogenesis --

The disease with the following factors : the surrogate less vitamin K through placenta, fetal liver stocks lower; Second, no birth gut bacteria, less synthetic vitamin K; ¢Û vitamin K content of human milk was only 15 L (60 ¦Ìg L milk. Therefore breastfeeding newborn infants prevalent; ¢Ü infants with congenital hepatobiliary disease or chronic diarrhea, affect the intestinal absorption of vitamin K; ¢Ý mothers during pregnancy had used drugs inhibit vitamin K metabolism.

Vitamin K does not participate in Coagulation Factor II, vii ¢ù, ¢ú synthesis But the clotting factor protein precursor of glutamic acid residues in the liver cells in vivo carboxymethyl particles into gamma-carboxyglutamic acid. to chelate more calcium, and then has the coagulation activity and participation in this process by vitamin K. So in the majority of patients by vitamin K treatment, the clotting mechanism can improve quickly. However, due to premature infants immature liver, the clotting factor precursor protein synthesis is also inadequate, the effect of vitamin K poor.

[Clinical]

Can be divided into three types of the disease, early onset and late-onset classic, which is common in infants.

(1) early-onset within 24 hours after onset. Common interference in the use of surrogate vitamin metabolism of drugs such as anticoagulants (doxorubicin), the anticonvulsant drugs (phenytoin sodium. phenobarbital), the anti-tuberculosis medicine (RFP). Have cephalohematoma intracranial, chest or abdominal bleeding.

(2) 2-3 days after the onset of classical, premature infants can be moved back two weeks. Common sites for umbilical stump bleeding, gastrointestinal tract (hematemesis or melena), pressure and skin puncture; If other epistaxis, party informed. Less pulmonary bleeding, vaginal bleeding occasionally. Generally small or moderate bleeding for more self-limited, one week after bleeding minimal.

(C) one month after the birth of late-onset disease, and certain related factors. and long-term use of antibiotics such as diarrhea, liver diseases and breast-feeding. Prevalent intracranial hemorrhage, the prognosis is poor.

[Treatment]

Children are bleeding, it should immediately intravenous vitamin Forty 1mg. rapidly improve hemorrhage; serious, to be supplied fresh whole blood or plasma 10"20ml/kg; gastrointestinal bleeding temporarily when fasting, intravenous nutritional supplements; hemostasis should be appropriate to correct anemia.

[Prevention]

All pregnant women are used anticoagulant, anti-tuberculosis drugs or antiepileptic drug history, K10mg prenatal vitamins should be given intramuscularly, 3-5 days; 20 mg twice weekly oral vitamin k1 lactating mothers. More effective methods of prevention are still not sure. Immediately after birth intramuscular vitamin k1 1"2mg,; If it takes long-term total parenteral nutrition baby, or a liver, gall disease, intestinal absorption and breastfeeding, should one regular weekly supplement of vitamin k1 0.5mg.

This article was posted on 2007-02-27