新生儿重度贫血的临床分析  

Clinical analysis of neonatal severe anemia in early stage

作　　者：邢继伟[1] 刘巍巍[1] 王亚娟 Xing Jiwei;Liu Weiwei;Wang Yajuan(Neonatal Intensive Care Unit,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院新生儿科,100026 [2]首都儿科研究所附属儿童医院新生儿科

出　　处：《北京医学》2021年第4期300-303,共4页Beijing Medical Journal

摘　　要：目的通过对新生儿重症监护室(neonatal intensive care unit,NICU)收治的24 h内新生儿重度贫血患儿进行临床分析,提高对新生儿重度贫血及其危险因素的关注,以早期预防、早期诊治,改善预后。方法选取2012年1月至2020年10月首都医科大学附属北京妇产医院NICU收治的出生24 h内临床诊断为新生儿重度贫血的患儿27例,记录产母围产情况,患儿合并症、实验室检验结果,分析贫血的原因及特点。结果新生儿重度贫血共27例,其中早产儿13例,足月儿14例;10例存在产前胎动减少、4例羊水Ⅲ度污染、13例胎心监护异常(其中4例为正弦波)、5例宫内超声提示胎胎输血。27例患儿Hb为27~83 g/L,19例网织红细胞增高,10例红细胞酸洗脱染色明显升高。临床病因:胎胎输血及胎母输血各10例,宫内感染2例,胎盘早剥1例,病因不明4例。4例因病情危重于生后24 h内死亡,2例因预后不良家属放弃治疗后死亡,其余患儿均痊愈。结论新生儿早期重度贫血是新生儿期急重症之一,临床表现隐匿,病因复杂,需严密观察胎儿变化,及时进行胎心监护及超声等相关检查,适时终止妊娠以改善新生儿预后。Objective To analyze the clinical data of newborns with severe anemia within 24 hours of NICU to improve the attention to the early stage of severe anemia and its risk factors,prevent early and improve prognosis by conducting.Methods Retrospective analysis of severe anemia cases of newborns within 24 hours of birth received by Neonatal Intensive Care Unit of Beijing Obstetrics and Gynecology Hospital from January 2012 to October 2020 was conducted.Maternal perinatal conditions,complications of the children,laboratory test results and outcomes were recorded,and the causes and characteristics of anaemia were analyzed.Results A total of 27 neonates diagnosed with severe anemia within the first 24 hours after birth were enrolled,including 13 preterm neonates,and 14 term neonates.There were 10 cases with prenatal fetal movement reduction,four cases with gradeⅢamniotic fluid contamination,13 cases with fetal heart monitoring abnormalities(of which four cases with sine waves),five cases with fetofetal transfusion syndromes detected by intrauterine ultrasonography.The Hb level of 27 neonates ranged from 27 to 83 g/L.Reticulocyte count showed an increase in 19 cases,and the erythrocyte acid elution staining increased significantly in 10 cases.Clinical and etiological analysis of 27 cases of severe anemia was conducted in this study.Fetofetal transfusion existed in 10 cases,fetomaternal transfusion existed in 10 case,infection was observed in two cases,placental abruption was observed in one case,and the etiology was unknown in four cases.Four cases died within 24 hours after birth due to critical condition,two cases with poor prognostic died due to abandoning treatment,and the rest got all recover from illness and left hospital.Conclusions Severe anemia is one of the most acute and severe diseases in neonatal period.The clinical features are secluded and no specific,and the causes are perplexing.Therefore,it is necessary to closely observe fetal changes,timely monitor fetal heart rate and carry out ultrasound and other

关 键 词：新生儿 重度贫血 早期 

分 类 号：R722.1[医药卫生—儿科]