胎龄<32周早产儿输血相关危险因素分析  

Analysis of risk factors associated with blood transfusion in preterm infants with gestational age<32 weeks

作　　者：朱毓书 高君艳 王伏东 蒋丽军 吴明赴[2] Zhu Yushu;Gao Junyan;Wang Fudong;Jiang Lijun;Wu Mingfu(Department of Pediatrics,Jiangdu People's Hospital Affiliated to Medical College of Yangzhou University,Yangzhou 225200,China;Department of Pediatrics,Affiliated Hospital of Yangzhou University,Yangzhou 225001,China)

机构地区：[1]扬州大学附属江都人民医院儿科,扬州225200 [2]扬州大学附属医院儿科,扬州225001

出　　处：《国际医药卫生导报》2024年第2期258-262,共5页International Medicine and Health Guidance News

基　　金：江苏省妇幼健康科研项目(F202071)。

摘　　要：目的探讨胎龄<32周早产儿输血情况及危险因素,为临床降低早产儿输血率提供依据。方法回顾性分析2018年1月至2022年12月扬州大学附属医院收治的130例胎龄<32周早产儿的临床资料,根据是否输血分为输血组(61例)和未输血组(69例)。输血组男30例、女31例,胎龄(29.79±1.66)周;未输血组男36例、女33例,胎龄(31.13±1.02)周。对比两组患儿一般资料、孕母资料、诊治情况等差异,并通过单因素和多因素logistic回归分析影响胎龄<32周早产儿输血的危险因素。符合正态分布的计量资料采用独立样本t检验,偏态分布的计量资料采用秩和检验,计数资料使用χ^(2)检验。结果在130例胎龄<32周早产儿中,输血治疗者61例,输血率为46.92%。单因素分析结果显示,输血组患儿胎龄、出生体质量、出生时血红蛋白(Hb)值、红细胞压积(HCT)、小于胎龄儿比例均低于未输血组[(29.79±1.66)周比(31.13±1.02)周、(1334.05±304.29)g比(1631.45±245.64)g、(166.00±24.77)g/L比(184.43±19.00)g/L、(51.04±7.95)%比(56.35±6.37)%、9.84%(6/61)比23.19%(16/69)],差异均有统计学意义(t=-5.450、-6.160、-4.689、-4.164,χ^(2)=4.106;均P<0.05)。输血组患儿生后2周内采血量及出生1 min Apgar评分≤7分、应用机械通气、需气管插管、呼吸暂停、新生儿呼吸窘迫综合征(NRDS)、支气管肺发育不良(BPD)、新生儿坏死性小肠结肠炎(NEC)比例均高于未输血组[(28.63±8.25)ml/kg比(20.84±5.27)ml/kg、42.62%(26/61)比13.04%(9/69)、95.08%(58/61)比60.87%(42/69)、19.67%(12/61)比1.45%(1/69)、68.85%(42/61)比34.78%(24/69)、72.13%(44/61)比52.17%(36/69)、21.31%(13/61)比1.45%(1/69)、14.75%(9/61)比2.90%(2/69)],差异均有统计学意义(t=6.324,χ^(2)=14.398、21.349、11.946、15.036、5.448、11.305、4.444;均P<0.05)。输血组患儿肠外营养时间、达足量喂养时间、吸氧时间、住院时间均长于未输血组[21.00(15.00,31.00)d比11.00(8.00,17.00)d、23.00(17.00,33.00)d�Objective To explore the red blood cell(RBC)transfusion situation and its risk factors in preterm infants with gestational age(GA)<32 weeks,and to provide clinical basis for reducing the blood transfusion rate of premature infants.Methods The clinical data of 130 premature infants with GA<32 weeks admitted to Affiliated Hospital of Yangzhou University from January 2018 to December 2022 were retrospectively analyzed.They were divided into a blood transfusion group and a non-blood transfusion group based on whether they received blood transfusion or not.In the blood transfusion group,there were 30 males and 31 females,with a gestational age of(29.79±1.66)weeks.In the non-blood transfusion group,there were 36 males and 33 females,with a gestational age of(31.13±1.02)weeks.By comparing the general data,maternal information,diagnosis and treatment status,etc.,and the risk factors affecting blood transfusion in premature infants with GA<32 weeks were analyzed through univariate and multivariate logistic regression analysis.Independent sample t test was used for the measurement data with normal distribution,rank sum test was used for the measurement data with skew distribution,andχ^(2) test was used for the count data.Results Among the 130 preterm infants with GA<32 weeks,61 cases were treated with blood transfusion,with an incidence of 46.92%.The results of univariate analysis showed that the gestational age,birth weight,hemoglobin(Hb)value at birth,hematocrit(HCT),and small-for date-infant ratio of the blood transfusion group were all lower than those of the non-blood transfusion group[(29.79±1.66)weeks vs.(31.13±1.02)weeks,(1334.05±304.29)g vs.(1631.45±245.64)g,(166.00±24.77)g/L vs.(184.43±19.00)g/L,(51.04±7.95)%vs.(56.35±6.37)%,9.84%(6/61)vs.23.19%(16/69)],with statistically significant differences(t=-5.450,-6.160,-4.689,and-4.164,χ^(2)=4.106;all P<0.05).The amount of blood collection within 2 weeks after birth and the proportions of Apgar score 1 min after birth≤7 points,mechanical ventilation,trachea

关 键 词：贫血 输血 早产儿 胎龄<32周 机械通气 危险因素 

分 类 号：R722.6[医药卫生—儿科]