Prophylactic Dosing of Vitamin Kto Prevent Bleeding维生素K的预防性给药 预防出血

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1、ProphylacticDosingofVitaminKtoPreventBleedingMauriWitt,MD,aNinaKvist,MD,bMarianneHørbyJørgensen,MD,PhD,cJanB.F.Hulscher,MD,PhD,aHenkjanJ.Verkade,MD,PhD,dalso,onbehalfoftheNetherlandsStudygroupofBiliaryAtresiaRegistry(NeSBAR)BACKGROUNDANDOBJECTIVES:Basedonahighin

2、cidenceofVitaminKdeficiencybleeding(VKDB)abstractinbreastfedinfantswiththusfarunrecognizedcholestasis,suchasbiliaryatresia(BA),theDutchregimentopreventVKDBinbreastfedinfantswaschangedfromadailyoraldosageof25μgto150μgvitaminK.Infantscontinuedtoreceive1mgofvitamin

3、Korallyatbirth.Wecomparedtheefficacyofthe150-μgregimenwiththe25-μgregimenandwiththeDanishregimenofasingleintramuscular(IM)doseof2mgvitaminKatbirth.METHODS:DatawereretrievedfromthenationalBAregistries:25μggroup(Netherlands,January1991toFebruary2011);150μggroup(Ne

4、therlands,March2011toJanuary2015);andIM2mggroup(Denmark,July2000toNovember2014).WecomparedtheincidenceofVKDBinthegroups.RESULTS:VKDBoccurredin45of55(82%)infantsofthe25μggroup,in9of11(82%)ofthe150μggroup,butinonly1of25(4%)oftheIM2mggroup(P<.001).Fortypercentofall

5、infantsofthe25μggrouphadanintracranialhemorrhageaspresentingsymptom,comparedwith27%oftheinfantsofthe150μggroup(P=.43).IntracranialhemorrhagewasnotobservedintheIM2mggroup(0%;P<.001).CONCLUSIONS:AvitaminKprophylacticregimenof1mgofvitaminKorallyatbirthfollowedbyada

6、ilyoraldosageofeither25or150μgfailstopreventVKDBinbreastfedinfantswithstillunrecognizedBA.Thedatasupport2mgvitaminKIMatbirthasprophylaxisagainstVKDB.aDepartmentofPediatricSurgeryanddPediatricGastroenterologyandHepatology,DepartmentofPediatrics,WHAT’SKNOWNONTHISS

7、UBJECT:TheDutchBeatrixChildren’sHospital,UniversityMedicalCenterGroningen,UniversityofGroningen,Groningen,guidelinetopreventvitaminKdeficiencybleedinginNetherlands;andDepartmentsofbPediatricSurgery,andcPediatricsandAdolescentMedicine,Universitybreastfedinfantshas

8、recentlybeenincreasedfromHospitalofCopenhagen,Copenhagen,Denmarkadailydoseof25μgto150μgvitaminK,basedonDrWittcollectedthedata,carriedouttheinitialanalyses,draftedthei