极早产儿贫血及输血治疗对组织氧饱和度及血压的影响

发布时间：2018-02-04 22:59

本文关键词： 极早产儿贫血脑肠道氧饱和度血压　出处：《中国现代医学杂志》2017年16期 　论文类型：期刊论文

【摘要】：目的贫血是极早产儿面临的常见问题之一,输血是最主要、最有效的治疗手段。然而,目前尚缺乏最佳的极早产儿输血指征。通过对脑及肠道组织氧饱和度和血压的监测,探讨贫血及输血对极早产儿组织氧供应及血压的影响,为极早产儿贫血合理输血治疗提供临床依据。方法选取28~31+6周极早产儿55例,分为4组:正常对照组、轻度贫血组、中度贫血组和重度贫血组。用近红外脑氧饱和度监测仪和多功能心电监护仪监测脑和肠道的氧饱和度和患儿的血压。结果输血前贫血组与对照组比较,脑及肠道氧饱和度均下降,差异有统计学意义(P0.05);不同贫血组之间比较,脑组织氧饱和度在中度与重度组间差异无统计学意义(P0.05);而轻度与中、重度组比较差异均有统计学意义(P0.05);肠道组织氧饱和度在轻度与中度组间差异无统计学意义(P0.05);而轻、中度与重度组比较差异有统计学意义(P0.05);各组间血压(包括收缩压、舒张压和平均动脉压)差异无统计学意义(P0.05);输血过程中,中度及重度组脑及肠道氧饱和度逐渐增高,两组比较差异有统计学意义(P0.05);输血后,脑氧饱和度中度组与重度组比较差异有统计学意义(P0.05);而肠道氧饱和度两组差异无统计学意义(P0.05);输血过程中及输血后血压与输血前比较差异无统计学意义(P0.05)。在输血过程中肠道氧饱和度比脑氧饱和度波动大,恢复快。输血后两者达到一个高值后趋于稳定。结论不同程度的贫血均可导致极早产儿脑组织及肠道组织供氧减少,随着贫血程度加重组织供氧明显减少,输血可以很快缓解组织缺氧的情况,且对血压无明显影响。值得注意的是在输血过程中肠道组织氧饱和度波动较大。
[Abstract]:Objective anemia is one of the most common problems faced by very premature infants. Blood transfusion is the most important and effective treatment. At present, the best indication of blood transfusion in very premature infants is lacking. The effects of anemia and blood transfusion on oxygen supply and blood pressure of very premature infants were investigated by monitoring oxygen saturation and blood pressure in brain and intestinal tissues. Methods 55 cases of extremely premature infants at the age of 2836 weeks were divided into 4 groups: normal control group and mild anemia group. The cerebral and intestinal oxygen saturation and the blood pressure of the children were monitored by near infrared cerebral oxygen saturation monitor and multifunctional ECG monitor. Results the blood pressure of the children was compared with that of the anemia group before blood transfusion. The oxygen saturation of brain and intestine decreased, and the difference was statistically significant (P 0.05). There was no significant difference in cerebral oxygen saturation between moderate and severe anemia groups (P 0.05). The difference between mild group and moderate group was statistically significant (P 0.05). There was no significant difference in intestinal tissue oxygen saturation between mild and moderate groups (P 0.05). The difference between mild, moderate and severe groups was statistically significant (P 0.05). There was no significant difference in blood pressure (including systolic blood pressure, diastolic blood pressure and mean arterial pressure) among the three groups (P 0.05). During the course of blood transfusion, the oxygen saturation of brain and intestine increased gradually in moderate and severe groups, and the difference between the two groups was statistically significant (P 0.05). After blood transfusion, the difference of cerebral oxygen saturation between moderate group and severe group was statistically significant (P 0.05). However, there was no significant difference in intestinal oxygen saturation between the two groups (P 0.05). There was no significant difference between blood pressure during and after blood transfusion and before blood transfusion. Intestinal oxygen saturation fluctuated more than cerebral oxygen saturation during blood transfusion. After blood transfusion, both reached a high value and then tended to stabilize. Conclusion anemia of different degrees can lead to the decrease of oxygen supply in brain and intestinal tissues of extremely premature infants, and the oxygen supply to tissues decreases with the increase of anemia degree. Blood transfusion can relieve tissue hypoxia quickly and has no obvious effect on blood pressure. It is worth noting that oxygen saturation of intestinal tissue fluctuates greatly during blood transfusion.
【作者单位】：南方医科大学附属陆军总医院附属八一儿童医院新生儿科;
【分类号】：R722.6
【正文快照】： 随着现代医疗技术水平的不断提高,极早产存活率大大提高,极早产儿贫血也成为一个比较常见的问题。贫血严重影响极早产儿的生长发育,导致免疫力低,发育落后。极早产儿贫血的早期防治对患儿的疾病恢复及健康成长极为重要。对极早产儿贫血的治疗,目前多采用成分输血、补充铁剂、

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