洗涤红细胞输注在早产儿贫血中的应用价值分析

Analysis of the Application Value ofWashed Red Blood Cell Transfusion for the Anemia of Premature Infants

目的:分析洗涤红细胞输注在早产儿贫血中的应用价值。方法:选取2015年10月~2017年11月我院需要输血治疗的贫血早产儿107例,均具有《早产儿管理指南》中的输血指征。采用随机数字表法将患儿分为两组,对照组53例输注红细胞悬浮液,观察组54例输注洗涤红细胞。比较两组患儿输血情况、治疗前后血液流变学相关指标、亚硝基硫醇(RSNO)、超氧化物歧化酶(SOD)和苯二醛(MDA)水平的变化及并发症的发生情况。结果:两组患儿输血量、输血次数、输血后血细胞压积和输血后血红蛋白水平比较均无统计学差异(P>0.05)。输血前,两组患儿全血高切黏度、全血低切黏度、血浆黏度、RSNO、SOD和MDA水平比较无统计学差异(P>0.05);输血后,两组全血高切黏度、全血低切黏度及血浆黏度均较输血前显著下降,且观察组以上指标均显著低于对照组(P<0.05);对照组患儿RSNO、SOD水平显著下降,MDA水平显著升高(P<0.05),观察组患儿以上指标均无显著变化(P>0.05)。观察组患儿呼吸暂停和院内感染的发生率显著低于对照组(P<0.05),两组脑白质损伤及颅内出血的发生率比较均无统计学差异(P>0.05)。结论:洗涤红细胞输注可显著改善贫血早产儿的血液流变学,降低应激反应及呼吸暂停和院内感染的发生率,且输血量、输血次数、输血后血细胞压积和输血后血红蛋白水平与输注红细胞悬浮液相当。

Objective:To analyze the application value of washed red blood cell transfusion for the premature infant anemia.Methods:107 cases of anaemic premature infants needing blood transfusion in our hospital were selected from October 2015 to November 2017.The children were divided into two groups by the random number table method.53 cases in the control group were given erythrocyte suspension,and 54 cases in the observation group were given erythrocyte washing.The changes of blood rheology,nitrite mercaptanol(RSNO),superoxide dismutase(SOD)and phenyldialdehyde(MDA)levels before and after blood transfusion,and the incidence of complications were compared between the two groups.Results:There was no statistically significant difference in the blood transfusion volume,times of blood transfusion,hematocrit after blood transfusion and hemoglobin level after blood transfusion between the two groups(P>0.05).Before transfusion,there was no statistically significant difference in the whole blood high tangential viscosity,whole blood low tangential viscosity,plasma viscosity,RSNO,SOD and MDA levels between the two groups(P>0.05).After blood transfusion,the whole blood high tangential viscosity,whole blood low tangential viscosity and plasma viscosity of both groups were significantly lower than those before blood transfusion,and the above indicators in the observation group were significantly lower than those in the control group(P<0.05).The levels of RSNO and SOD in the control group were significantly decreased,while the levels of MDA were significantly increased(P<0.05),the above indicators showed no significant difference in the observation group(P>0.05).The incidence of apnea and nosocomial infection in the observation group was significantly lower than that in the control group(P<0.05),and there was no statistical difference in the incidence of white matter injury and intracranial hemorrhage between the two groups(P>0.05).Conclusion:Washing red blood cell infusion can significantly improve the hemorheology of premature infants with anemia,reduce the incidence of stress reaction,apnea and nosocomial infection,and the blood transfusion volume,times,hematocrit after blood transfusion and the hemoglobin level after blood transfusion are equivalent to that of the transfusion of red blood cell suspension.