极低出生体重儿红细胞输注的危险因素分析

Analysis of risk factors associated with red blood cell transfusion in very low birth weight infants

目的:确立极低出生体重儿红细胞输注的独立危险因素,并探讨独立危险因素数量与红细胞输注发生率之间的关系。方法:对2020年6月至2021年3月在华中科技大学同济医学院附属武汉儿童医院住院治疗的出生体重≤1500 g的患儿进行回顾性分析,根据有无红细胞输注,将患儿分为输血组和非输血组。比较2组的临床资料、检查结果、临床并发症和住院期间的治疗措施,以确定红细胞输注的危险因素,并分析极低出生体重儿输血危险因素数量与红细胞输注发生率的关系。结果:70例极低出生体重儿中,44例接受红细胞输注,输注率为62.9%,输血组与非输血组比较,患儿的出生体重、住院身长、住院天数、妊娠天数、妊娠并发症总数以及5 min Apgar评分<7分、机械通气、肺出血、支气管肺发育不良、脓毒血症、颅内出血、住院天数>40 d的例数差异有统计学意义,多因素二元logistic回归分析表明,机械通气、5 min Apgar评分<7分和妊娠并发症是极低出生体重儿红细胞输注的独立临床预测因素,极低出生体重儿输血危险因素数量与红细胞输注发生率的关系呈正相关。结论:新生儿成熟度和临床严重程度相关的临床特征与极低出生体重儿红细胞输注显著相关,随着极低出生体重儿危险因素数量的增加,输注红细胞的可能性增加。

Objective:To determine independent risk factors of red blood cell(RBC)transfusion in very low birth weight(VLBW)infants and explore the association between the number of RBC transfusion risk factors in VLBW infants with morbidity of RBC transfusion.Methods:VLBW infants with birth weight≤1500 g admitted to our hospital from June 2020 to March 2021 were retrospectively analyzed,the infants were divided into the blood transfusion group and the non-blood transfusion group according to RBC transfusion status.The clinical data,examination results,clinical complications and treatment measures during hospitalization were compared between the two groups to determine risk factors of RBC transfusion,and then,the association between the number of RBC transfusion risk factors in VLBW infants with morbidity of RBC transfusion were analyzed.Results:Of 70 VLBW infants enrolled,44 received RBC transfusion with the RBC transfusion rate of 62.9%,compared with VLBW infants in non-transfusion group,the general data of birth weight,height in hospitalization,hospitalization day,gestational day,the total number of pregnancy complications,Apgar score at 5 minutes<7,mechanical ventilation,pulmonary hemorrhage,BPD,sepsis,IVH,hospitalization day>40 days had significant difference in VLBW infants in transfusion group,multivariate binary logistic regression analysis showed that mechanical ventilation,Apgar score at 5 minute<7 and pregnancy complications were independent clinical predictors for RBC transfusion in VLBW infants and there was a positive relationship between morbidity of RBC transfusion and the number of RBC transfusion risk factors in VLBW infants.Conclusion:The clinical characteristics related to neonatal maturity and clinical severity were significantly associated with the indication for RBC transfusion in VLBW infants and the possibility of RBC transfusion increased with the increase of the number of risk factors in VLBW infants.