新生兒에 있어서 血液 凝固 能力과 vitamin K의 效果에 對한 檢討

Abstract

[한글]

[영문]

Hemorrhagic disorder of the newborn infant was first described in 1894 by Dr. Townsend. Since then the etiology, therapy and prophylaxis have aroused great interest.

The object of the present study is 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 domonstrate a temporary depression of the coagulation factors, which include Factor Ⅱ, Factor Ⅶ, Factor Ⅸ and Factor Ⅹ.

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 received a vitamin K preparation.

According to this method, a risk of hemorrhage is believed to occur when the thromootest percentage (T.T. %) is below 10.

We have used "Menaidone sodium Bisulfite" (Hykinone) from the vitamin K preparations, because it is much less expensive and used widely in general clinic. One hundred and forty four healthy full-term newborne and fourteen premature babies were investigated.

The newborn subjects were divided into 5 groups and premature;

Group Ⅰ. consisted of 45 newborn infants who did not receive vitamin K after birth (Fig. 1.)

Group Ⅱ. consisted of 34 newborn infants who received 2 mg of Hykinone intramuscularly after birth. (Fig. 2.)

Group Ⅲ. consisted of 35 inafants whose mothers had received 10mg of Hykinone intramuscularly 4 to 24 hours before delivery. (Fig.3.)

Group Ⅳ. consisted of 15 infants who received 5 mg oral Hykinone immediately after birth. (Fig. 4.)

Group Ⅴ. consisted of 15 infants whose mothers had received 20 mg oral Hykinone 4 to 24 hours before delivery. (Fig. 5.)

Premature group. consisted of 14 premature babies who did not receive vitamin K after birth. Their weights were between 1780 gm to 2499 gm. (Fig. 6.)

Using a new method of thrombotest, we found in these groups that coagulation defect of 2nd and 3rd day of life is so great as to constitute a risk of hemorrhage.

These phenomena could be prevented in groups of administering Hykinone (Group Ⅱ, Ⅲ, Ⅳ & V), especially to the mother 4 to 24 hours prior to delivery, either orally or intramuscularly. (Group Ⅲ & Ⅴ)

In premature group, the thrombotest value in average was low compared with that of control group.

The risk of jaundice in the newborn infants who received Hykinone or whose mothers had received Hykinone was also investigated, and showed that a single dose of Hykinone did not cause hyperbilirubinemia. (Table 3.)

From the above findings, it is concluded that vitamin K prophylaxis is advantageous to all newborn babies in order to prevent hemorrhagic disorders during the 2nd 3rd day of life.