极早产儿输血相关危险因素分析

Blood transfusion and related risk factors in very premature infants

目的通过回顾性分析探讨胎龄<32周极早产儿输血情况,并进行高危因素分析,为临床降低早产儿输血率的管理提供参考。方法收集2018年6月—2019年5月本院收治的182例极早产儿的临床资料,根据是否输血分为输血组和未输血组,比较2组患儿的一般情况、住院期间疾病发生情况及治疗措施。结果 182例极早产儿中,胎龄(29.9±1.79)周,出生体质量(1400.6±320.7)g,住院期间输血率为18.13%(33/149),进行输血1次、2次、3次和5次分别有63.64%(21/33)、21.21%(7/33)、6.06%(2/33)和9.09%(3/33)。2组极早产儿分别在胎龄、出生体质量、单/双胎、分娩方式、出生时血红蛋白值及红细胞压积、住院期间总采血量、住院时间、吸氧时间、肠外营养时间、新生儿呼吸窘迫综合征、新生儿坏死性小肠结肠炎、支气管肺发育不良、颅内出血、败血症、视网膜病变、宫外生长迟缓方面有统计学意义(P<0.05)。多因素Logistic回归分析显示,住院期间总的采血量、吸氧时间、剖宫产和宫外生长迟缓是极早产儿输血的高危因素(P<0.05)。结论极早产儿易发生输血,剖宫产出生、住院期间总的采血量越多、吸氧时间越长,发生宫外生长迟缓的极早产儿越易发生输血。

Objective To retrospectively analyze the blood transfusion rate and related high risk factors of very premature infants with gestational age<32 weeks,so as to provide references for reducing blood transfusion rate of premature infants.Methods Clinical data of 182 very premature infants admitted to our hospital from June 2018 to May 2019 were collected.They were divided into blood transfusion group and non-transfusion group according to receiving transfusion or not.The general data,disease occurrence and treatment measures of the two groups were compared.Results For the 182 very premature infants,the gestational age was(29.9±1.79)weeks and the birth weight was(1400.6±320.7)g.The blood transfusion rate during hospitalization was 18.13%(33/149),and 63.64%(21/33),21.21%(7/33),6.06%(2/33)and 9.09%(3/33)of the infants received blood transfusion once,twice three and five times,respectively.Statistical significances in gestational age,birth weight,singleton/twins,delivery mode,hemoglobin value and hematocrit at birth,total blood collection during hospitalization,hospital stay,oxygen inhalation time,parenteral nutrition time,neonatal respiratory distress syndrome,neonatal necrotizing enterocolitis,bronchopulmonary dysplasia,intraventricular hemorrhage,septicemia,retinopathy and extrauterine growth retardation were notable between groups(P<0.05).Multivariate logistic regression analysis showed that the total blood collection,the time of oxygen inhalation,cesarean birth and extrauterine growth retardation were high risk factors for blood transfusion in very premature infants,(P<0.05).Conclusion Very premature infants are prone to blood transfusion,especially those with Cesarean birth,extrauterine growth retardation,lager volume of blood collection and longer oxygen inhalation time during hospitalization.