超低出生体重儿及超早产儿输血治疗的相关危险因素分析

Aretrospective analysis of correlative risk factors of blood transfusion therapy for extremely low birth weight infants and extremely preterm infants

目的分析超低出生体重儿及超早产儿在不同时期进行输血治疗的相关危险因素,并探讨贫血的预防策略。方法回顾性分析空军军医大学唐都医院儿科2013年1月至2018年12月新生儿重症监护室(NICU)收治的出生体重<1 000g的超低出生体重儿及胎龄<28周的超早产儿,根据首次输血时间分为早期输血组(首次输血时间在出生2周内)和晚期输血组(首次输血时间在出生2周后),分析两组患儿一般情况、产时危险因素、输血前临床特征及输血后并发症等。结果共纳入患儿42例,其中早期输血组19例(45.24%),晚期输血组23例(54.76%)。与晚期输血组相比,早期输血组出生体重更低(t=2.04,P<0.05)、住院时间更长(t=2.05,P<0.05)。经单因素分析发现,早期输血组支气管肺发育不良(BPD)及早产儿视网膜病变(ROP)的发病率高于晚期输血组(χ~2值分别为4.40、4.50,均P <0.05)。结论超低出生体重儿及超早产儿早期输血与ROP及BPD的发生密切相关,该类患儿应尽量避免早期输血治疗。

Objective To analyze correlative risk factors of early blood transfusion for extremely low birth weight infants and extremely preterm infants and explore strategies for prevention of anemia. Methods The clinical data of extremely low birth weight infants with birth weight less than 1000 g and extremely preterm infants with gestational age less than 28 weeks who admitted to NICU in our hospital from January, 2013 to December, 2018 were retrospectively analyzed. According to time of first blood transfusion, the infants were divided into early blood transfusion group(first blood transfusion at less than 2 weeks after birth) and late blood transfusion group(first blood transfusion at more than or equal to 2 weeks after birth). The general situation, perinatal risk factors, pretransfusion clinical features and related complications after blood transfusion of the infants in the two groups were analyzed. Results A total of 42 infants were included:19 in the early blood transfusion group(45.20%) and 23 in the late blood transfusion group(54.76%). The birth weight of the infants in the early blood transfusion group was lower(t = 2.04, P<0.05), and hospital stay was longer than those in the late blood transfusion group(t = 2.05, P<0.05). Single factor analysis revealed that the incidences of bronchopulmonary dysplasia(BPD) and retinopathy of premature infants(ROP) of the infants in the early blood transfusion group were both higher than those in the late blood transfusion group(χ2 = 4.40, χ2 =4.50 respectively, both P < 0.05). Conclusion Early blood transfusion for extremely low birth weight infants and extremely preterm infants is closely correlated to ROP and BPD. For these infants, early blood transfusion therapy after birth should be avoided as far as possible.