不同输血方法对贫血早产儿预后的影响

摘要

目的 探究不同输血方式对贫血早产儿预后的影响.方法 回顾性分析2016年3月至2018年3月期间在本院治疗的80例贫血早产儿的临床资料,参考美国2008年早产儿输血指南与中国输血诊疗常规分成对照组(限制性输血)与观察组(积极性输血),各40例,比较两组输血情况、治疗情况及预后情况.结果 观察组初次输血红细胞比容(Hct)为(33.24±1.03)％,高于对照组的(30.16±0.79)％;观察组平均每人输血总量为(35.41±3.65) ml、平均每人输血次数为(1.52±0.52)次,低于对照组的(70.16±4.01) ml、(2.65±0.46)次;两组比较差异均有统计学意义(均P＜0.05);观察组吸氧时间为(14.06±2.21)d、机械通气时间为(7.32±4.06)d、无创持续正压通气时间为(6.05±4.51)d、住院时间为(30.27±4.32)d,低于对照组的(18.53±2.94)d、(10.62±5.67)d、(10.53±3.46)d、(36.51±4.16)d,两组比较差异均有统计学意义(均P＜ 0.05);观察组慢性肺疾病发生率为0.00％、视网膜病变发生率为2.50％、院内感染发生率为17.50％、呼吸暂停发生率为12.50％、颅内出血发生率为5.00％、脑白质损伤发生率为2.50％,均低于对照组的15.00％、20.00％、40.00％、35.00％、20.00％、20.00％,差异有统计学意义(P＜0.05);观察组病死率为5.00％,低于对照组的10.00％,但差异无统计学意义(P＞0.05).结论 积极性输血治疗贫血早产儿疗效明显优于限制性输血,可促进患儿Hct提升,增强免疫功能,减少并发症发生,改善预后.%Objective To explore the effect of different blood transfusion methods on prognosis of anemic premature infants.Methods The clinical data of 80 cases of anemic premature infants treated in our hospital from March 2016 to March 2018 were retrospectively analyzed.According to the United States 2008 blood transfusion guidelines for premature infants and Chinese blood transfusion routine,80 cases were divided into control group (restrictive blood transfusion) and observation group (active transfusion),40 cases in each group.The blood transfusion,treatment status,and prognosis of the two groups were compared.Results The Hct of the observation group was higher than that of the control group [(33.24±1.03)％ vs.(30.16±0.79)％],and the average amount of blood transfusion per person and the number of times of blood transfusion per person in the observation group were lower than those of the control group [(35.41±3.65)ml vs.(70.16±4.01) ml,(1.52±0.52) times vs.(2.65±0.46)times] (P＜0.05).The oxygen inhalation time,mechanical ventilation time,noninvasive continuous positive pressure ventilation time,and hospitalization time in the observation group were (14.06±2.21)d,(7.32±4.06)d,(6.05±4.51)d,(30.27±4.32)d,shorter than those in the control group [(18.53±2.94) d,(10.62±5.67)d,(10.53±3.46)d,(36.51±4.16)d] (P＜0.05).The incidences of chronic lung disease,retinopathy,nosoeomial infection,apnea,intracranial hemorrhage,and white matter injury in the observation group were 0.00％,2.50％,17.50％,12.50％,5.00％,2.50％,lower than those in the control group (15.00％,20.00％,40.00％,35.00％,20.00％,20.00％) (P＜0.05).The mortality of the observation group was slightly lower than that of the control group (5.00％ vs.10.00％),but the difference was not statistically significant (P＞0.05).Conclusion The therapeutic effect of active blood transfusion on anemic premature infants is better than that of restrictive blood transfusion,which can promote the development of Hct,enhance immune function,reduce complications,and improve prognosis.