Lin Li, Xu Hongzhen, Chen Lan, et al. Clinical study of 320 children with hypofibrinogenaemia. [J]. Journal of Chongqing Medical University 41(6):645-649(2016)
Lin Li, Xu Hongzhen, Chen Lan, et al. Clinical study of 320 children with hypofibrinogenaemia. [J]. Journal of Chongqing Medical University 41(6):645-649(2016) DOI: 10.13406/j.cnki.cyxb.000926.
Clinical study of 320 children with hypofibrinogenaemia
Objective:To probe the clinical and laboratory features of childhood hypofibrinogenaemia
and to provide the clinical evidence for the further administration and prevention of severe hemorrhage. Methods:The clinical data(including the position and seriousness of hemorrhage
the incidence of hemorrhage
clinical complication
and the therapeutic response)of 320 hospitalized children with decreased plasma fibrinogen level(FIB≤1.0 g/L)were retrospectively analyzed by SPSS PASW18.0 software with Kruskal-Wallis Test and T-test(Kruskal-Wallis Test for the seriousness and incidence of hemorrhage
T-test for the therapeutic response). The significance level was set at P<0.05
and P value was corrected according to the sample size and statistics. Results:Totally 320 children(193 males and 127 females) were identified
in which the newborn accounted for 51.6%(165 cases). 281 cases(87.8%)were complicated with reported secondary factors leading by liver dysfunction(55.9 %)
259 cases(80.9%)were complicated with other coagulation disorders. Most cases(162 cases
50.6%)suffered from mild fibrinogen deficiency. There was no hemor-rhage in 171 cases(53.4%)and 149 cases developed hemorrhage(46.6%). Among the hemorrhage cases
47.0% developed mild and36.9% suffered from severe hemorrhage. It’s quite significant that some of the severe hemorrhage cases just got mild or moderate FIB deficiency. There was no significant difference in bleeding morbidity(P=0.149)and severity(P=0.088)among cases under different severities of hypofibrinogenaemia. If FIB deficiency combined with other coagulopathy or thrombocytopenia
both the bleeding morbidity(P <0.05) and severity(P <0.05) were significantly increased. Bleeding occurred in any system
especially in gastrointestinal tract. Fibrinogen product supplementation either FFP or cryoprecipitate were given to 40.3% hemorrhagic patients and 34.5% nonhemorrhagic patients respectively and part of them had FIB follow-up. Fibrinogen level of both groups had significantly elevated
indicating that fibrinogen products could restore plasma fibrinogen level. Conclusion:Hemorrhage possibly occurs when plasma fibrinogen decreased and severe hemorrhage can even occur in patient with mild hypofibrinogenaemia. Children with hypofibrinogenaemia should be carefully and considerably administered with appropriate products and be closely followed up.