胎儿宫内输血治疗的临床应用分析  

Analysis on Clinical Application of Fetal Intrauterine Transfusion

作　　者：刘成义[1] 陈源 李欢 何薇[1] 陈泽仪 穆小萍[1] LIU Cheng-yi;CHEN Yuan;LI Huan(Department of Blood Transfusion,Guangdong Women and Children Hospital,Guangzhou Guangdong 511442)

机构地区：[1]广东省妇幼保健院,广州511442

出　　处：《临床输血与检验》2022年第1期38-42,共5页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：广东省医学科研基金项目(No.A2020599)资助。

摘　　要：目的探讨胎儿宫内输血治疗的临床应用情况,分析宫内输血治疗与短期妊娠结局的相关性。方法回顾性分析2017年1月~2021年5月于广东省妇幼保健院收治并进行宫内输血治疗的病例,分为胎儿存活组和非存活组,比较两组宫内输血的原因、输血量、输血次数、首次宫内输血孕周及宫内输血前后胎儿血红蛋白浓度(Hb)、红细胞比容(HCT)和大脑中动脉收缩期血流峰值流速(MCA-PSV)的变化情况。运用SPSS13.0统计软件对数据进行统计学分析。结果共纳入34例宫内输血治疗病例,其中胎儿存活19例,非存活15例;共进行了63次宫内输血,主要输血原因为:原因不明性贫血、双胎输血综合征、母胎血型不合和胎盘血管瘤;输血后两组胎儿的Hb和HCT都显著升高,MCA-PSV较输血前明显下降,差异有统计学意义(P<0.001);多因素Logistic回归分析显示,首次宫内输血孕周(OR=1.49,P=0.041)和宫内输血次数(OR=6.72,P=0.025)是胎儿存活的保护因素。结论宫内输血应用范围广,可显著改善胎儿贫血情况。Objective To investigate the clinical application of intrauterine transfusion therapy,and to analyze the influence of intrauterine transfusion(IUT)therapy on short-term pregnancy outcomes.Methods We retrospectively analyzed the cases who were admitted to the Guangdong Women and Children Hospital and received IUT from January 2017 to June 2021.Clinical data were divided into Fetus survival group and non-survival group based on the fetuses’condition.The reasons and frequency for IUT,gestational age at the first IUT and fetal hemoglobin concentration(Hb),hematocrit(HCT)and peak systolic blood flow velocity of the middle cerebral artery(MCA-PSV)changes were compared between two groups.The data was statistically analyzed by SPSS 13.0 software.Results A total of 34 cases of IUT were included,of which 19 fetuses were alive and 15 were non-survivors.We performed 63 IUTs and the main causes of IUT were unexplained anemia,twin-fetal transfusion syndrome,maternal-fetal blood group incompatibility,and placental hemangioma.The Hb and HCT of the fetuses in the two groups were significantly increased,and the MCA-PSV was significantly lower after IUT(P<0.001).Logistic regression analysis indicated that the gestational week of the first IUT(OR=1.49,P=0.041)and IUT frequency(OR=6.72,P=0.025)were protective factors for fetal survival.Conclusion IUT has a wide range of applications,which can significantly improve the fetal anemia.

关 键 词：宫内输血 贫血 妊娠结局 孕期胎儿 

分 类 号：R457[医药卫生—治疗学]