180例极低出生体质量儿输血情况及危险因素分析

发布时间：2018-04-02 16:29

本文选题：极低出生体质量儿　切入点：贫血　出处：《临床儿科杂志》2017年05期

【摘要】：目的探讨极低出生体质量儿(VLBWI)输血情况及危险因素。方法回顾分析2012年1月至2016年6月收治的180例VLBWI的临床资料,并根据是否输血分为输血组及未输血组,比较两组VLBWI的一般资料、住院期间疾病发生情况及治疗措施。结果 180例VLBWI中,住院期间发生贫血118例(65.6%),需输血57例(31.7%),出生胎龄(31.3±1.9)周,出生体质量(1 295.7±127.7)g,首次输血多发生于生后2~5周,每次输血量为20 m L/kg,48例(84.2%)住院期间仅输血1次。两组VLBWI分别在母孕期贫血、出生体质量、胎龄、出生时血红蛋白值及红细胞压积、输血前采血量、生后采集脐血、住院时间、持续气道正压通气时间、肠外营养时间、血管活性药物使用时间、分娩方式、出生后是否需气管插管、新生儿呼吸窘迫综合征、呼吸暂停、暂时性甲状腺功能减退症、动脉导管未闭方面有统计学意义(P均0.05)。多因素logistic回归分析显示,胎龄越大、出生体质量越大、出生时血红蛋白值越高,VLBWI输血率越低;而住院时间越长、输血前采血量越大,则VLBWI输血率越高(P均0.05)。结论 VLBWI输血率较高,住院期间多种并发症、病情危重、早期医源性失血量及出生时血红蛋白值是影响输血率的重要因素。
[Abstract]:Objective to investigate the status and risk factors of VLBWI transfusion in very low birth weight infants.Methods the clinical data of 180 cases of VLBWI admitted from January 2012 to June 2016 were retrospectively analyzed and divided into two groups according to whether blood transfusion was given or not. The general data of VLBWI, the incidence of disease during hospitalization and the treatment measures were compared between the two groups.In the two groups, the maternal anemia, birth weight, gestational age, hemoglobin at birth and hematocrit, blood volume before blood transfusion, umbilical blood collection after birth, hospitalization time, duration of continuous positive airway pressure ventilation, and parenteral nutrition were observed in both groups.The time of use of vasoactive drugs, the delivery mode, the need for tracheal intubation after birth, neonatal respiratory distress syndrome, apnea, temporary hypothyroidism and patent ductus arteriosus were all significantly different (P < 0.05).Multivariate logistic regression analysis showed that the larger the gestational age, the greater the birth weight, the higher the hemoglobin value at birth and the lower the transfusion rate of VLBWI, and the longer the hospital stay, the larger the blood collection before transfusion, the higher the transfusion rate of VLBWI was.Conclusion the blood transfusion rate of VLBWI is high, many complications during hospitalization, serious illness, early iatrogenic blood loss and the value of hemoglobin at birth are the important factors affecting the blood transfusion rate.
【作者单位】：第四军医大学西京医院儿科;
【分类号】：R457.1;R722

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