血红蛋白定量红细胞输注在新生儿输血中的应用  

The application of quantithtive transfusion of hemoglobin in neonates

作　　者：刘俊 康炜[2] 宋翠春 孙锐 

机构地区：[1]大连市妇幼保健院检验科,大连116033 [2]大连市血液中心成分科,大连116001 [3]大连市妇幼保健院新生儿科,大连116033

出　　处：《中国医师杂志》2016年第12期1833-1836,共4页Journal of Chinese Physician

摘　　要：目的建立血红蛋白定量红细胞输注方法，并探讨此输血方法在新生儿输血中的应用。方法选取大连市妇幼保健院重症监护新生儿科的有输血指征的新生儿93例，按体重和日龄相匹配的原则分为两组，第一组（对照组：常规方法）按0．15U／kg正常预约输注辐照去白洗涤红细胞两次，输血前和输血后24h内检测血红蛋白值，并在制备小量红细胞悬液的过程中检测红细胞悬液的血红蛋白、体积和压积，通过这些数值计算出血红蛋白在输注红细胞新生儿体内的利用率。第二组（观察组：血红蛋白定量红细胞输注）按照医生期望患儿输注红细胞后所达到的血红蛋白值以及通过第一组患儿所得到的血红蛋白在输注红细胞新生儿体内的利用率反向计算出患儿需要补充多少血红蛋白，再按照此标准制备辐照去白洗涤红细胞小量悬液进行血红蛋白定量输注两次，输血前和输血后24h内检测血红蛋白值，对所得结果进行统计分析。结果两种方法都能够有效的改善患儿体内贫血情况（P〈0．05），两种方法在改善患儿贫血程度上差异无统计学意义（P〉0．05），但血红蛋白定量红细胞输注（标准差s=6．6，变异系数cv=4．6％）基本能够达到医生所期望的血红蛋白值，不会像第一种方法（s=14．45，cv=8．6％）那样出现输注后少数血红蛋白过高或者少数没有达到完全改善患儿体内贫血情况。结论传统红细胞输注方法和血红蛋白定量红细胞输注方法都能够有效改善患儿体内贫血，但血红蛋白定量红细胞输注方法更能够符合临床需求，达到临床期望值，做到真正的定量红细胞输注。Objective To establish the quantitative transfusion of hemoglobin method and explore the application of this method in neonatal transfusion. Methods This study selected 93 cases of anemic neonates who had no other underlying diseases from the Neonatal Department of Maternal and Child Health （MCH） in Dalian, and they were the principle of weight and age divided into two groups. The first group （control group： conventional method） was transfused and injected the red blood cells that were leukocyte- reduced, irradiated and washed twice by 0. 15 U/kg under the normal reservation. The study measured the hemoglobin value before transfusion and within 24 h after being transfused, and then detected the hemoglo- bin, volume, and hematocrit of a small amount of blood during the preparation, and finally calculated the u- tilization rate of hemoglobin in neonates who were transfused. For the second group （ observation group ： quantitative erythrocyte injection of hemoglobin）, it calculated in reverse how much hemoglobin the children needed to be supplemented, based on the doctor＇s expected hemoglobin values achieved after children being transfused and the utilization rate of hemoglobin obtained from the first group. Then, according to the calculation, it prepared a small amount of blood of the red blood cells that were leukocyte-reduced, irradiated and washed, made the quantitative injection of hemoglobin twice, and measured the hemoglobin value before transfusion and within 24 h after being transfused. At last, it analyzed statistically the results. Results Both two methods effectively imwoved the children＇s anemia （ P 〈 0. 05 ）. There was no difference （ P 〉 0. 05） for two methods in improving the anemia of children, but the quantitative transfusion of hemoglobin （s = 6. 6, cv = 4. 6% ） could basically reach the doctor＇s expected hemoglobin value, and it avoided the sit- uations in the first method （s = 14.45, vc = 8.6% ）, like that after transfusion a minority of hemoglobin was to

关 键 词：红细胞输注 输血 血红蛋白类 婴儿 新生 

分 类 号：R457.1[医药卫生—治疗学]