新生儿换血治疗后不良反应及其危险因素分析

Analysis of the risk factor of adverse events associated with neonatal exchange transfusion

目的探讨新生儿换血后的不良反应及其危险因素。方法选择于2009年10月～2010年10月在我院新生儿科行换血治疗的71例患儿为研究对象,全部71例患儿均采用外周动静脉同步换血术。换血后的不良反应定义为换血7d内发生的任何一种并发症。采用回顾性分析方法,记录患儿性别、胎龄、换血时体重、换血日龄、换血前、中、后各种血液和基本生命指标。结果①不良反应发生率最高的为血小板减少,为63.38%。本研究纳入样本中未发生DIC及NEC;②不良反应与原发疾病没有确切的相关性;③换血时间在7d以内是换血不良结局的危险因素(P<0.05),而性别、孕周、体重差异则无统计学意义。结论新生儿换血治疗存在不良反应的危险,最常见的是血小板减少,不良反应的发生与原发疾病没有确切的相关性,在生后7d内换血是其危险因素。

Objective To investigate the adverse events associated with neonatal exchange transfusion and its risk factors.Methods 71 newborn received exchange transfusion who were hospitalized in our NICU during October 2009 to October 2010 were investigated.Adverse events was defined as serious complications occurring within one week of exchange transfusion,including hyperkalemia,hypocalcemia,hypoglycemia,thrombocytopenia et al.Correlative factors include sex,gestational age,weight.Results The most common adverse events in the exchange transfusion was thrombocytopenia,others including hyperkalemia,hypocalcemia,hypoglycemia et al.Age less than 7 days when exchange transfusion was independent risk factor.Conclusion Most common adverse event of exchange transfusion in newborn was thrombocytopenia,age less than 7 days when exchange transfusion was the only independent risk factor we found.