本文選題：極低出生體質(zhì)量兒　切入點：貧血　出處：《臨床兒科雜志》2017年05期

【摘要】：目的探討極低出生體質(zhì)量兒(VLBWI)輸血情況及危險因素。方法回顧分析2012年1月至2016年6月收治的180例VLBWI的臨床資料,并根據(jù)是否輸血分為輸血組及未輸血組,比較兩組VLBWI的一般資料、住院期間疾病發(fā)生情況及治療措施。結果 180例VLBWI中,住院期間發(fā)生貧血118例(65.6%),需輸血57例(31.7%),出生胎齡(31.3±1.9)周,出生體質(zhì)量(1 295.7±127.7)g,首次輸血多發(fā)生于生后2~5周,每次輸血量為20 m L/kg,48例(84.2%)住院期間僅輸血1次。兩組VLBWI分別在母孕期貧血、出生體質(zhì)量、胎齡、出生時血紅蛋白值及紅細胞壓積、輸血前采血量、生后采集臍血、住院時間、持續(xù)氣道正壓通氣時間、腸外營養(yǎng)時間、血管活性藥物使用時間、分娩方式、出生后是否需氣管插管、新生兒呼吸窘迫綜合征、呼吸暫停、暫時性甲狀腺功能減退癥、動脈導管未閉方面有統(tǒng)計學意義(P均0.05)。多因素logistic回歸分析顯示,胎齡越大、出生體質(zhì)量越大、出生時血紅蛋白值越高,VLBWI輸血率越低;而住院時間越長、輸血前采血量越大,則VLBWI輸血率越高(P均0.05)。結論 VLBWI輸血率較高,住院期間多種并發(fā)癥、病情危重、早期醫(yī)源性失血量及出生時血紅蛋白值是影響輸血率的重要因素。
[Abstract]:Objective to investigate the status and risk factors of VLBWI transfusion in very low birth weight infants.Methods the clinical data of 180 cases of VLBWI admitted from January 2012 to June 2016 were retrospectively analyzed and divided into two groups according to whether blood transfusion was given or not. The general data of VLBWI, the incidence of disease during hospitalization and the treatment measures were compared between the two groups.In the two groups, the maternal anemia, birth weight, gestational age, hemoglobin at birth and hematocrit, blood volume before blood transfusion, umbilical blood collection after birth, hospitalization time, duration of continuous positive airway pressure ventilation, and parenteral nutrition were observed in both groups.The time of use of vasoactive drugs, the delivery mode, the need for tracheal intubation after birth, neonatal respiratory distress syndrome, apnea, temporary hypothyroidism and patent ductus arteriosus were all significantly different (P < 0.05).Multivariate logistic regression analysis showed that the larger the gestational age, the greater the birth weight, the higher the hemoglobin value at birth and the lower the transfusion rate of VLBWI, and the longer the hospital stay, the larger the blood collection before transfusion, the higher the transfusion rate of VLBWI was.Conclusion the blood transfusion rate of VLBWI is high, many complications during hospitalization, serious illness, early iatrogenic blood loss and the value of hemoglobin at birth are the important factors affecting the blood transfusion rate.
【作者單位】： 第四軍醫(yī)大學西京醫(yī)院兒科;
【分類號】：R457.1;R722

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