限制性与非限制性输血用于治疗早产儿贫血的临床研究  

Clinical study of restrictive versus liberal transfusion strategies for the treatment of anemia in preterm infants

作　　者：周佩艳 方晓丹[1] Zhou Peiyan;Fang Xiaodan(Newborn Intensive Care Unit,Jinhua People's Hospital,Jinhua321015,Zhejiang Province,China)

机构地区：[1]金华市人民医院新生儿重症监护病房,金华321015

出　　处：《中国基层医药》2024年第12期1810-1814,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省金华市科学技术研究项目(2020-4-041)。

摘　　要：目的分析不同输血阈值(限制性输血与非限制性输血)对早产儿贫血预后的影响。方法采用回顾性研究, 选取金华市人民医院2019年12月至2022年2月收治的早产儿贫血80例为研究对象, 按照输血阈值不同分为对照组(限制性输血)和研究组(非限制性输血), 每组40例。记录患儿生命体征指标, 统计患儿输血及康复情况, 观察患儿输血相关并发症发生情况。结果研究组末次输血后24 h心率[(142.41±8.39)次/min]、呼吸频率[(43.51±5.27)次/min]均显著低于对照组[(150.78±8.15)次/min和(48.76±5.49)次/min], 而血氧饱和度[(96.21±1.47)%]显著高于对照组[(94.59±1.82)%](t=-5.29、-5.77、6.38, 均P < 0.05);两组平均动脉压差异均无统计学意义(均P > 0.05)。两组输血次数和输血总量差异均无统计学意义(均P > 0.05);研究组首次输血日龄、脱氧时间、完全经口喂养时间、奶量达足量时间和住院时间分别为(12.46±2.91)d、(14.92±3.16)d、(16.34±3.36)d、(20.59±3.41)d和(31.72±5.52)d, 均显著短于对照组的(18.85±3.27)d、(19.57±3.42)d、(21.86±3.58)d、(24.07±3.82)d和(36.49±5.76)d(t=-10.63、-7.35、-8.47、-5.63、-6.05, 均P < 0.001)。研究组支气管肺发育不良、脑损伤发生率分别为12.5%(5/40)、7.5%(3/40), 均显著低于对照组的35.0%(14/40)和25.0%(10/40)(χ^(2)=5.59、4.50, 均P < 0.05)。结论限制性输血策略用于治疗早产儿贫血, 并不会增加输血暴露风险, 并且可以有效改善患儿生命体征, 促进患儿快速康复, 降低输血相关并发症发生率。ObjectiveTo analyze the effects of different transfusion thresholds(restrictive versus liberal transfusion)on the prognosis of anemia in preterm infants.MethodsA retrospective study was conducted involving 80 preterm infants with anemia who received treatment at Jinhua People's Hospital from December 2019 to February 2022.The infants were divided into two groups based on different transfusion thresholds:the control group(restrictive transfusion)and the study group(liberal transfusion),with 40 patients in each group.Vital signs were recorded,and the transfusion and recovery outcomes were analyzed.Additionally,the occurrence of transfusion-related complications was calculated.ResultsIn the study group,the heart rate[(142.41±8.39)beats/minute]and respiratory rate[(43.51±5.27)breaths/minute]24 hours after the last transfusion were significantly lower than those in the control group[(150.78±8.15)beats/minute,(48.76±5.49)breaths/minute],while the oxygen saturation[(96.21±1.47)%]was significantly higher than that in the control group[(94.59±1.82)%,t=-5.29,-5.77,6.38,all P<0.05].There was no statistically significant difference in mean arterial pressure between the two groups(P>0.05).The number of transfusions and total volume of blood transfused did not differ significantly between the two groups(both P>0.05).The age at first transfusion,time to wean off ventilatory support,time to achieve full oral feeding,time to reach sufficient milk intake,and length of hospital stay in the study group were(12.46±2.91)days,(14.92±3.16)days,(16.34±3.36)days,(20.59±3.41)days,and(31.72±5.52)days,respectively.These values were significantly shorter than those in the control group[(18.85±3.27)days,(19.57±3.42)days,(21.86±3.58)days,(24.07±3.82)days,(36.49±5.76)days,t=-10.63,-7.35,-8.47,-5.63,-6.05,all P<0.001].The incidence of bronchopulmonary dysplasia and brain injury in the study group was 12.5%(5/40)and 7.5%(3/40),respectively.These incidences were significantly lower than those in the control group[35.0%(14/40),25.0%(

关 键 词：婴儿 早产 贫血 输血 生命体征 预后 心率 动脉压 住院时间 

分 类 号：R722.6[医药卫生—儿科]