极低出生体重儿输血并发症的影响因素分析  

Analysis of influencing factors of blood transfusion complications in very low birth weight infants

作　　者：欧阳足兰 刘鑫[2] 倪建萍 龙浴皎 OUYANG Zulan;LIU Xin;NI Jianping;LONG Yujiao(Department of Blood Transfusion,Women and Children's Hospital of Ningbo University,Ningbo,315012,China;Department of Laboratory,Women and Children's Hospital of Ningbo University)

机构地区：[1]宁波大学附属妇女儿童医院输血科,浙江宁波315012 [2]宁波大学附属妇女儿童医院检验科

出　　处：《临床血液学杂志》2024年第8期563-567,共5页Journal of Clinical Hematology

基　　金：浙江省医药卫生科技计划项目(No:2024KY1567)。

摘　　要：目的:研究输血对极低出生体重儿(VLBWI)常见并发症发病率的影响因素分析。方法:选取医院新生儿重症监护病房2020年1月1日—2022年12月31日期间住院治疗的361例VLBW患儿作为研究对象,其中输注去白细胞悬浮红细胞的VLBW患儿324例(输血组),未输血患儿37例(未输血组)。回顾性分析输血对患儿并发症的影响,比较输血组与未输血组VLBWI常见并发症发病率的差异,分析首次输血时间、输血次数对VLBWI并发症的影响及输血相关坏死性小肠结肠炎(NEC)的危险因素。结果:输血组与未输血组VLBWI比较,输血组支气管肺发育不良(BPD)、NEC、脑室出血(IVH)、新生儿败血症发病率显著高于未输血组(P<0.05)。VLBWI输血后BPD、NEC、早产儿视网膜病变(ROP)发病率分别为72.53%、18.21%、15.74%。VLBWI早期输血组(首次输血时间在出生2周内)BPD、NEC、ROP、新生儿喂养不耐受发生率显著高于晚期输血组(首次输血时间在出生2周后)(P<0.05),而新生儿败血症发生率差异无统计学意义(P>0.05)。VLBWI输血≥3次组BPD、NEC、ROP、IVH、新生儿喂养不耐受、新生儿败血症发病率显著高于输血<3次组(P<0.05)。多因素logistic回归分析显示,输血次数是NEC的独立危险因素(OR=1.211,95%CI 1.017~1.444,P=0.032)。结论:VLBWI相关并发症发生可能与输血有关,首次输血时间越早、输血次数越多,相关并发症发病率越高。应减少早期输血和输血次数,从而降低相关并发症的发生。Objective: To study the influence and factor analysis of blood transfusion on the incidence of common complications in very low birthweight infants(VLBWI).Methods: A total of 361 VLBW children hospitalized in the neonatal intensive care unit from January 1,2020 to December 31,2022 were selected as the study subjects,including 324 VLBW children who received leucocyte suspended red blood cells(transfusion group)and 37 children who did not receive transfusion(non-transfusion group).The effects of blood transfusion on the complications of children were retrospectively analyzed,and the differences in the incidence of common complications of VLBWI between the transfusion group and the non-transfusion group were compared.The effects of the time of first transfusion and the number of transfusion on the complications of VLBWI and the risk factors of transfusion-related necrotizing enterocolitis(NEC)were analyzed.Results: The incidence of bronchopulmonary dysplasia(BPD),NEC,ventricular hemorrhage(IVH)and septicemia in VLBWI transfusion group was significantly higher than that in non-transfusion group(P<0.05).The incidence of BPD,NEC and retinopathy of prematurity(ROP)after VLBWI transfusion were 72.53%,18.21%and 15.74%,respectively.The incidence of BPD,NEC,ROP and neonatal feeding intolerance in VLBWI early transfusion group(the first transfusion was within 2 weeks of birth)was significantly higher than that in late transfusion group(the first transfusion was after 2 weeks of birth)(P<0.05),while the incidence of neonatal sepsis was not statistically significant(P>0.05).The incidence of BPD,NEC,ROP,IVH,neonatal feeding intolerance and sepsis in≥3 VLBWI transfusion group were significantly higher than those in<3 transfusion group(P<0.05).Multivariate logistic regression analysis showed that the number of transfusions was an independent risk factor for NEC(OR=1.211,95%CI 1.017-1.444,P=0.032).Conclusion: The incidence of VLBWI related complications may be related to blood transfusion.The earlier the first transfusion time a

关 键 词：极低出生体重儿 输血 并发症 

分 类 号：R457.1[医药卫生—治疗学]