极低出生体重儿红细胞输注疗效及其影响因素分析  

Analysis of the effect and influencing factors of red blood cell infusion in very low birth weight infants

作　　者：欧阳足兰 倪建萍[1] 龙浴皎 OUYANG Zulan;NI Jianping;LONG Yujiao(Department of Blood Transfusion,Ningbo Women and Children's Hospital,Ningbo,315012,China)

机构地区：[1]宁波市妇女儿童医院输血科,浙江宁波315012

出　　处：《临床血液学杂志》2024年第2期94-98,共5页Journal of Clinical Hematology

摘　　要：目的:研究影响极低出生体重儿(VLBWI)红细胞输注疗效的因素,提高临床VLBWI输血疗效。方法:选取医院新生儿重症监护室2020年1月1日—2021年12月31日,输注去白细胞悬浮红细胞的VLBWI患儿258例作为研究对象。根据VLBWI的胎龄、出生体重、输血有效性进行分组,回顾性分析不同胎龄、体重VLBWI输血效果及影响VLBWI输血疗效的因素。分析输血后24 h血红蛋白(Hb)上升值与临床指标的相关性,比较输血前后代谢指标和电解质指标的差异。结果:VLBWI输血后Hb、红细胞比容(HCT)显著升高,升高均值分别为(37.31±17.32) g/L、(10.56±5.60)%;VLBWI胎龄越小、体重越轻,其输血前Hb越高、输血次数越多、住院时间越长;输血有效组和输血无效组比较,其中胎龄、出生体重、输血次数、输血间隔时间、输血量差异有统计学意义(P<0.05),而Apgar评分、红细胞储存时间差异无统计学意义(P>0.05);输血后24 h Hb上升值与胎龄、出生体重、输血量呈正相关(P<0.05),与输血前Hb值呈负相关(P<0.05),与Apgar评分、红细胞储存时间无相关性(P>0.05);VLBWI输血后24 h总胆红素显著高于输血前(P<0.05),而输血前、输血后24 h酸碱度、乳酸的差异无统计学意义(P>0.05);患儿输血后24 h血钠、血钾显著高于输血前(P<0.05)。结论:胎龄、出生体重、输血量影响VLBWI输血疗效,红细胞储存时间与输血疗效无相关性,VLBWI输血后应密切关注总胆红素、血钠、血钾的变化。Objective: To study the factors affecting the efficacy of red blood cell transfusion in very low birth weight infants(VLBWI)and improve the efficacy of clinical VLBWI transfusion.Methods: From January 1,2020 to December 31,2021,258 VLBWI children who were transfused with leukocyte-free suspended red blood cells in neonatal intensive care unit were selected as the study objects.According to the gestational age,birth weight and transfusion effectiveness of VLBWI,the effects of different gestational age and weight VLBWI transfusion and the factors affecting the efficacy of VLBWI transfusion were retrospectively analyzed.The correlation between hemoglobin(Hb)rise value and clinical indexes at 24 h after transfusion was analyzed,and the differences of metabolic indexes and electrolyte indexes before and after transfusion were compared.Results: Hb/HCT increased significantly after VLBWI transfusion,and the mean increases were(37.31±17.32)g/L and(10.56±5.60)%,respectively.The smaller the gestational age and the lighter the weight of VLBWI,the higher the Hb before transfusion,the more the number of transfusion and the longer the hospital stay.There were significant differences in gestational age,birth weight,blood transfusion times,blood transfusion interval and blood transfusion volume between effective and ineffective transfusion groups(P<0.05),but no significant differences in Apgar score and red blood cell storage time(P>0.05).Hb rise value at 24 h after transfusion was positively correlated with gestational age,birth weight and transfusion volume(P<0.05),but negatively correlated with Hb value before transfusion(P<0.05),and had no correlation with Apgar score and red blood cell storage time(P>0.05).Total bilirubin at 24 h after VLBWI transfusion was significantly higher than that before transfusion(P<0.05),but there was no significant difference in pH and lactic acid between before transfusion and 24 h after transfusion(P>0.05).Blood sodium and potassium at 24 h after transfusion were significantly higher than tho

关 键 词：极低出生体重儿 红细胞输注 输血疗效 影响因素 

分 类 号：R457.1[医药卫生—治疗学]