NICU新生儿输注血液制剂的现状分析  

Analysis of the current status of neonatal blood transfusion in NICU

作　　者：刘海燕 LIU Haiyan(Department of Blood Transfusion,the First People's Hospital of Guiyang County in Chenzhou City of Hu'nan Province,Chenzhou,Hu'nan 424400,China)

机构地区：[1]湖南省郴州市桂阳县第一人民医院输血科,湖南郴州424400

出　　处：《检验医学与临床》2024年第5期677-681,686,共6页Laboratory Medicine and Clinic

摘　　要：目的 分析新生儿重症监护室(NICU)新生儿输注血液制剂的现状,为更好地指导新生儿输血提供参考依据。方法 回顾性收集2012年1月至2022年12月该院NICU收治的406例输注血液制剂新生儿的病历资料,分析新生儿输注红细胞、血浆、冷沉淀及血小板的分布特点以及输注前后血常规指标[血红蛋白(Hb)、红细胞比容(HCT)、红细胞分布宽度(RDW)、平均红细胞血红蛋白含量(MCH)、平均红细胞血红蛋白浓度(MCHC)、红细胞平均体积(MCV)]、凝血指标[国际标准化比率(INR)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]、生化指标[总胆红素、直接胆红素、间接胆红素、肌酐、尿素氮、血清钾离子]水平。结果 406例新生儿疾病分布为新生儿呼吸窘迫综合征206例,新生儿黄疸105例,新生儿肺炎67例,新生儿溶血病11例,新生儿贫血7例,新生儿颅内出血3例,新生儿脓毒症3例,其他疾病4例。381例输注红细胞的新生儿中极早早产儿输注例数、次数及输注量均明显高于足月产儿、晚期早产儿、中期早产儿和早期早产儿,差异均有统计学意义(P<0.05);超低出生体质量儿输注例数、次数及输注量均明显高于正常体质量儿、低出生体质量儿和极低出生体质量儿,差异均有统计学意义(P<0.05)。73例输注血小板的新生儿中极早早产儿、超低出生体质量儿输注例数均明显高于其他组,差异均有统计学意义(P<0.05)。血液制剂输注后,新生儿血常规指标中Hb、HCT水平均明显高于输注前,而MCH、MCV水平均明显低于输注前,差异均有统计学意义(P<0.05);新生儿凝血指标中APTT水平明显低于输注前,差异有统计学意义(P<0.05);新生儿生化指标中总胆红素、直接胆红素、间接胆红素水平均高于输注前,而尿素氮水平明显低于输注前,差异均有统计学意义(P<0.05)。血液制剂输注前后,新生儿各指标中RDW、MCHC、INR、PT、肌酐、血清钾离Objective To analyze the current situation of blood products transfusion in neonatal intensive care unit(NICU),and to provide reference bases for better guidance of neonatal blood transfusion.Methods The medical records of 406 neonates who were admitted to the NICU of the hospital from January 2012 to December 2022 were retrospectively collected.The distribution characteristics of red blood cells,plasma,cryoprecipitate and platelets in the neonates were analyzed,and the routine blood test results[hemoglobin(Hb),hematocrit(HCT),red blood cell distribution width(RDW),mean corpuscular hemoglobin content(MCH),mean corpuscular hemoglobin concentration(MCHC),and mean corpuscular volume(MCV)],the levels of coagulation indicators[international normalized ratio(INR),prothrombin time(PT),activated partial thromboplastin time(APTT)] and biochemical indicators[total bilirubin,direct bilirubin,indirect bilirubin,creatinine,urea nitrogen and serum potassium] before and after transfusion were analyzed.Results The disease distribution of 406 neonates receiving blood products transfusion was as follows:206 cases of neonatal respiratory distress syndrome.There were 105 cases of neonatal jaundice,67 cases of neonatal pneumonia,11 cases of neonatal hemolytic disease,7 cases of neonatal anemia,3 cases of neonatal intracranial hemorrhage,3 cases of neonatal sepsis,and 4 cases of other diseases.Among the 381 neonates who received red blood cell transfusion,the number of cases,times and volume of red blood cell transfusion in very early preterm infants were significantly higher than those in term,late preterm,moderate preterm,and early preterm infants,and the differences were statistically significant(P<0.05).The number of cases,times and volume of transfusion in extremely low birth weight infants were significantly higher than those in normal weight infants,low birth weight infants and very low birth weight infants,and the differences were statistically significant(P<0.05).Among the 73 neonates who received platelet transfusion,the tra

关 键 词：新生儿 输血 红细胞 血浆 冷沉淀 血小板 

分 类 号：R272.1[医药卫生—中医儿科学] R457.1[医药卫生—中医学]