不同体重新生儿输血治疗溶血病的疗效比较

Comparison of blood transfusion efficacy in neonatal with different body weights in hemolytic disease

目的:了解新生儿整体输血情况,比较不同体重新生儿输血治疗溶血病(HDN)的效果。方法:回顾性统计1036例输血的患儿,分为低体重组和正常体重组。比较2组患儿一般情况、疾病分布及抗体分布情况;比较2组HDN患儿输血情况及输血前后血红蛋白、总胆红素、纤维蛋白原、PT、APTT变化水平。结果:1036例输血患儿中,130例为HDN患儿,占12.55%,且低体重组(11.43%)与正常体重组(14.56%)的输血率差异无统计学意义(P=0.171)。抗体分布主要以Rh系统抗体为主。HDN患儿中,低体重组输注的红细胞(84.260±11.853)mL和血浆(18.92±0.99)mL明显高于正常体重组输注的红细胞(29.88±6.361)mL(P=0.000)和血浆(10.95±0.786)mL(P=0.000);2组输注的冷沉淀差异无统计学意义(P=0.94)。2组HDN患儿输血后的血红蛋白均明显上升,总胆红素均显著下降。结论:输血对于HDN的治疗有效且2组体重新生儿疗效无差别。

Objective:To understand the overall situation of neonatal transfusion and compare the efficacy of transfusion in newborns with different body weights in neonatal hemolytic disease(HDN).Method:A total of 1036 cases transfused newborn were retrospectively analyzed,which were divided into low body group and normal body group.The general conditions and disease distribution between the two groups were compared.The transfusion situation of patients with HDN and the changes of hemoglobin,total bilirubin,fibrinogen,PT and APTT before and after transfusion were compared.Result:Of the 1036 newborn with transfusion,130 were HDN newborn,accounting for 12.55%,and there was no significant difference(P=0.171)in transfusion rate between low body group(11.43%)and normal body group(14.56%).The antibody distribution is mainly based on Rh system antibodies.In HDN patients,red blood cells transfusion(84.260±11.853)mL and plasma transfusion(18.92±0.99)mL in low body group were significantly higher than red blood cells transfusion(29.88±6.361)mL(P=0.000)and plasma transfusion(10.95±0.786)mL(P=0.000)in normal body group.There was no statistical difference between the two groups in cryoprecipitate transfusion(P=0.94).After transfusion,hemoglobin increased and total bilirubin decreased significantly in two groups patients with HDN.Conclusion:Blood transfusion is effective for the treatment of HDN and there was no difference in the efficacy of two groups.