不同红细胞输注量对贫血早产儿脑和肠道组织氧饱和度的影响

The Effect of Different Red Blood Cell Infusion Volume on Oxygen Saturation of Brain and Intestinal Tissues in Anemic Premature Infants

目的比较常规输血量和高输血量的红细胞输注对贫血早产儿脑和肠道组织氧饱和度的影响。方法选取2020年1月至2021年5月福建省妇幼保健院新生儿科收治的出生胎龄<32周并输注红细胞治疗的129例早产儿的临床资料,根据红细胞输注策略分为常规输血量组(15 ml/kg)和高输血量组(20 ml/kg)。利用近红外光谱监测仪持续监测并对比两组红细胞输注前2 h(T_(0))、红细胞输注中(T_(1))及红细胞输注后2 h(T_(2))、2~6 h(T_(3))、6~12 h(T_(4))、12~24 h(T_(5))的局部脑组织氧饱和度(Cer rSO_(2))及肠道组织氧饱和度(Int rSO_(2)),利用多功能心电监护仪同步测量患儿心率(HR)、平均动脉压(MABP)和经皮动脉血氧饱和度(SpO_(2)),并计算患儿脑摄氧分数(cFTOE)以及肠摄氧分数(iFTOE)。结果129例患儿中,67例接受常规输血量红细胞输注,62例接受高输血量红细胞输注。T_(0)时,两组Cer rSO_(2)、Int rSO_(2)、cFTOE和iFTOE差异无统计学意义(P>0.05);T_(1)~T_(5)时,两组Cer rSO_(2)和Int rSO_(2)水平均升高,cFTOE和iFTOE值均降低。T_(2)时,两组HR均下降,MABP和SpO_(2)均升高。结论常规输血量和高输血量均能改善贫血早产儿脑和肠道组织氧饱和度及临床指标。

Objective The effects of red blood cell infusion with conventional blood transfusion volume and high blood transfusion volume on oxygen saturation of brain and intestinal tissues were compared and studied.Methods With the selection of clinical data of 129 preterm infants with gestational age<32 weeks and red blood cell infusion for treatment admitted to the Department of Neonatology,Fujian Maternal and Child Health Hospital from January 2020 to May 2021,the red blood cell transfusion group was divided into two subgroups:the conventional blood transfusion group(15 ml/kg)and the high blood transfusion group(20 ml/kg),according to the red blood cell transfusion strategy.The oxygen saturation in local cerebral tissue(Cer rSO_(2))and intestinal tissue(Int rSO_(2))of the two groups of children 2 hours before red blood cell infusion(T_(0)),during red blood cell infusion(T_(1)),and 2 hours after red blood cell infusion(T_(2)),2 to 6 hours(T_(3)),6 to 12 hours(T_(4)),12 to 24 hours(T_(5))were continuously monitored and compared,by using a near-infrared spectral monitor.The heart rate(HR),mean arterial pressure(MABP)and percutaneous arterial oxygen saturation(SpO_(2))of child patient were synchronously measured with a multi-function ECG monitor.Meanwhile,the cerebral oxygen uptake fraction(cFTOE)and intestinal oxygen uptake fraction(iFTOE)were calculated.Results With the study of 129 child patient(67 patients received round red blood cell transfer and 62 patients received high volume red blood cell transfer),there was no significant difference in Cer rSO_(2),Int rSO_(2),cFTOE and iFTOE between the two groups(P>0.05)at T_(0);The levels of Cer rSO_(2)and Int rSO_(2)in both groups increased,while the cFTOE and iFTOE values decreased,at T_(1)-T_(5);HR decreased,while MABP and SpO_(2)increased in both groups,at T_(2).Conclusion Both routine blood transfusion and high blood transfusion can improve the oxygen saturation of brain and intestinal tissues and clinical indicators of premature infants.