贫血早产儿输血过程脑部及腹部局部组织氧饱和度的变化及临床意义  

Changes and clinical significance of cerebral and abdominal regional tissue oxygen saturation in premature infants with anemia during blood transfusion

作　　者：陆镇奇 高平明[1] LU Zhen-qi;GAO Ping-ming(Department of Neonatology,Foshan Women and Children Hospital Affiliated to Southern Medical University,Foshan 528000,Guangdong,China)

机构地区：[1]南方医科大学附属佛山妇幼保健院新生儿科,广东省佛山市528000

出　　处：《广西医学》2022年第14期1600-1604,1609,共6页Guangxi Medical Journal

摘　　要：目的分析贫血早产儿输血过程中脑部局部组织氧饱和度(C-rSO)及腹部局部组织氧饱和度(A-rSO)的变化及临床意义。方法纳入25例需输注去白细胞悬浮红细胞的贫血早产儿(研究组)和25例尚未输血的贫血早产儿(对照组)。两组早产儿均接受常规治疗,明确输血指征后给予研究组早产儿输注去白细胞悬浮红细胞。于输血前2 h至输血结束后4 h监测两组早产儿心率、脉搏血氧饱和度(SpO)、A-rSO、C-rSO,并计算A-rSO/C-rSO比值。结果(1)在输血结束后1 h时,研究组的心率较前降低,且低于对照组(均P<0.05),而两组间的SpO差异无统计学意义(P>0.05)。(2)输血开始后,研究组的A-rSO、C-rSO、A-rSO/C-rSO值呈先上升后下降再回升的变化趋势(均P<0.05)。研究组输血开始后各时间点和输血结束后0.5 h、3 h、4 h的A-rSO,输血开始后各时间点和输血结束后各时间点的C-rSO,以及输血开始后各时间点和输血结束后0.5 h的A-rSO/C-rSO比值均高于对照组(均P<0.05);但输血结束后1 h、2 h的A-rSO,以及输血结束后1 h、2 h、3 h的A-rSO/C-rSO比值均低于对照组(均P<0.05)。结论贫血早产儿输血时A-rSO变化较大,表现为先升高后降低再逐渐回升的趋势,采用A-rSO/C-rSO比值结合A-rSO指导早产儿的输血管理可能更可靠。Objective To analyze the changes and clinical significance of brain regional tissue oxygen saturation(C-rSO) and abdominal regional tissue oxygen saturation(A-rSO) in premature infants with anemia during blood transfusion. Methods A total of 25 premature infants with anemia who needed infusion of leukocyte-reduced suspended red blood cells(the study group) and 25 premature infants with anemia but without receiving blood transfusion(the control group) were enrolled. Both groups of premature infants received routine treatment. After the indication of blood transfusion was explicit, the premature infants in the study group were given infusion of leukocyte-reduced suspended red blood cells. The heart rate, pulse oxygen saturation(SpO), A-rSO, and C-rSOof premature infants in both groups were monitored during 2 hours before and 4 hours after blood transfusion, and the ratio of A-rSO/C-rSOwas calculated.Results(1) One hour after the end of blood transfusion, the heart rate in the study group was lower than that before blood transfusion and in the control group(all P<0.05). There was no statistically significant difference in SpObetween the two groups(P>0.05).(2) After the start of blood transfusion, A-rSO, C-rSO, and A-rSO/C-rSOratio in the study group revealed a trend of increasing first, then decreasing, and then increasing again(all P<0.05). As compared with the control group, the study group exhibited higher A-rSOat various time points after the start of blood transfusion, and 0.5 hour, 3 hours, and 4 hours after the end of blood transfusion, higher C-rSOat various time points after the start of blood transfusion and after the end of blood transfusion, as well as higher ratio of A-rSO/C-rSOat various time points after the start of blood transfusion and 0.5 hour after the end of blood transfusion(all P<0.05);however, the study group interpreted lower A-rSO1 hour, and 2 hours after the end of blood transfusion, and lower A-rSO/C-rSOratio 1 hour, 2 hours, and 3 hours after the end of blood transfusion in the compariso

关 键 词：输血 贫血 早产儿 脑部 腹部 局部组织氧饱和度 

分 类 号：R725.56[医药卫生—儿科]