极早产儿与极低出生体重儿输血治疗的高危因素

Risk factors of blood transfusion in very preterm infants and very low birth weight infants

目的红细胞输注是治疗早产儿贫血的重要方法,探索红细胞输注治疗的高危因素,为在临床治疗中减少输血提供依据。方法选择出生胎龄小于32周的极早产儿或出生体质量小于1500 g的极低出生体质量儿为研究对象,按照住院期间是否进行红细胞输注治疗分为输血组与未输血组,应用SPSS软件统计分析两组患儿资料。结果共纳入117例患儿,其中输血患儿63例(53.8%),输血组患儿胎龄、出生体质量、1 min及5 min Apgar评分、入院血红蛋白浓度、入院红细胞压积均低于未输血组,失血量、呼吸支持时间、新生儿呼吸窘迫综合征、呼吸暂停、支气管肺发育不良、喂养不耐受发生率均高于未输血组,P<0.05。多因素Logistic回归分析显示,失血量多是输血治疗的独立危险因素,P=0.000。出生体质量越低,输血的概率越大,P=0.038。结论极早产儿与极低出生体重儿并发症多,输血概率高,住院期间失血量多是导致输血治疗的主要原因;出生体质量越低,输血的可能越大。

Objective Red blood cell(RBC)transfusion remains the important treatment of anemia in preterm infants,we attempted to explore the risk factors of transfusion and suggest ways to reduce the need for multiple transfusions in clinical treatment.Methods Very preterm infants with gestational age less than 32 weeks or very low birth weight infants with birth weight less than 1500 g were selected as the research objects.The infants were divided into the transfusion group and the non-transfusion group according to whether red blood cell transfusion was performed during hospitalization,and SPSS software was used to analyze the data of the two groups.Results Altogether 117 infants were enrolled in the study,and 63(53.8%)infants received red blood cell transfusion.Gestational age,birth weight,Apgar scores at 1 minute and 5 minutes,basal hemoglobin concentration at admission,and hematocrit at mission in the transfusion group were lower than those in the non-transfusion group.Blood loss,duration of respiratory support,incidences of neonatal respiratory distress syndrome,apnea,bronchopulmonary dysplasia and feeding intolerance were higher than those in the non-transfusion group(P<0.05).Multiple Logistic regression analysis revealed that large amount of blood loss was an independent risk factor for blood transfusion(P=0.000)and the lower the birth weight,the higher the probability of transfusion(P=0.038).Conclusion Very preterm infants and very low birthweight infants have more complications,higher probability of blood transfusion and more blood loss during hospitalization.The lower the birth weight,the greater the chance of transfusion.