246例危重早产儿检验性失血特点分析  

Analysis of characteristics of blood loss for laboratory test for 246 cases of critically ill premature infants

作　　者：文果 彭华保[2] 侯彰华[2] 欧永辉[2] 周丽芳[2] 

机构地区：[1]广东省清远市第一人民医院新生儿科,511515 [2]南华大学附属郴州市第一人民医院新生儿重症监护科,423000

出　　处：《国际儿科学杂志》2015年第2期213-217,共5页International Journal of Pediatrics

基　　金：湖南省科学技术厅科研项目（2013SK3264）

摘　　要：目的 分析危重早产儿检验性失血特点,寻求减少检验性失血的可行方案.方法 对2012年4月至2013年4月入住我院新生儿重症监护室（NICU）246例危重早产儿住院期间检验性失血情况及入院后前4周不同时期不同胎龄、不同出生体重儿检验性失血特征进行分析;并将所有采血项目分类,分析检验性失血的应用分布;应用公式B=5（∑s＋0.1）运算出理论需血量,根据实际采血量分析入院后前2周日人均多抽量的时间和人群特征及多抽量的显著项目.结果 每例患儿总检验性失血量中位数为25.57 ml（7.10～ 119.20） ml;失血量集中在入院后前4周,随时间呈递减趋势;前2周胎龄越小、出生体重越低,日人均失血量越多,差异有统计学意义（P＜0.05）,第3、4周差异无统计学意义（P＞0.05）;检验性失血的应用分布主要为生化测定（31.49％）、血气分析（19.03％）、免疫测定（12.69％）、血培养（12.63％）、血液学（12.28％）;总实际失血量约为总理论需血量的2倍,前者中位数25.57 ml为后者3.26ml的.8倍;第1周日人均多抽量高于第2周,差异具有统计学意义（P＜0.05）;血培养、生化测定、其他、血气分析构成多抽量最显著的采血项目,多抽比例依次为76％、64％、45％、41％.结论 危重早产儿检验性失血现状严峻,采血浪费现象严重;胎龄越小、出生体重越低,日人均失血量及多抽量越显著;生化测定及血气分析构成检验性失血的主要项目.Objective To analyze the characteristics of blood loss for laboratory test of critically ill premature infants,and to seek feasible measures to reduce the blood loss.Methods Two hundred and forty-six cases of critically ill premature infants admitted to the neonatal intensive care unit from April 2012 to April 2013 were analyzed the blood loss for test during the hospitalization and the clinical features of blood loss with different gestational age,different weight within the first four weeks after admission.Then the application of blood loss according to test category was described.The blood volume demanded in theory was determined by the formula B =5 （∑ s ＋ 0.1）,then calculated the phlebotomy overdraw on the basis of the practical blood loss and analyzed the characteristics of overdraw per patients per day in first two weeks after admission.Results Among 246 patients,The median blood loss figure was 25.57 ml for each infants with the range between 7.10 ml ～ 119.20 ml,and the blood loss concentrated in first four weeks,which showed a decreasing trend with time.There was a statistically significant difference（P 〈0.05）that the smaller gestational age,the lower birth weight,the more daily blood loss per patient per day in first two weeks,but no significant differences（P 〉 0.05） between the third and fourth week.The largest proportion of the blood samples was used for clinical chemical tests（31.49%）,followed by blood gas analysis （19.03%）,immunoassays （12.69%）,blood cultures （12.63%）,hematology （12.28%）.The practical blood loss was about twice times of blood volume demanded for tests in theory,which the median was 7.8 times to the latter（25.57 ml vs 3.26 ml）.It showed statistically significant difference（P 〈0.05） between blood overdraw per patients per day in the first week and the second week.Compared with different gestational age and birth weight,the difference of overdraw was also statistically significant（P 〈0.05）.According to test category,blood culture

关 键 词：早产儿 早产儿贫血 检验性失血 多抽量 

分 类 号：R722.6[医药卫生—儿科]