摘要
目的探讨限制性输血(RBT)和非限制性输血(LBT)对早产儿贫血的疗效。方法选择2015年1月至2017年12月,于贵州医科大学附属医院诊断为早产儿贫血,并接受红细胞输注(RBCT)治疗的264例早产儿为研究对象。回顾性分析其临床病例资料。根据采用的RBCT策略,将其分为RBT组(n=147)和LBT组(n=117)。对2组早产儿的一般临床资料、输血治疗及住院情况,以及输血相关疾病发生率等,采用独立样本t检验、χ^(2)检验及Wilcoxon秩和检验进行统计学比较。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求。结果①RBT组早产儿累计接受RBCT量及次数,输血后血红蛋白(Hb)与血细胞比容(HCT)升高幅度,以及机械通气、胃肠外营养及住院时间分别为90.0 mL(70.0~120.0 mL)、2次(2~2次)、(63.0±21.2)g/L、(17.5±6.2)%、10 d(3~18 d)、16 d(9~22 d)及31.0 d(23.0~38.0 d),均多于、高于、长于LBT组的80.0 mL(62.5~110.0 mL)、2次(1~2次)、(51.9±23.2)g/L、(13.8±7.1)%、0(0~3 d)、6 d(2~14 d)及17.0 d(9.5~26.5 d),并且差异均有统计学意义(Z=—2.134、P=0.033;Z=—3.588、t=4.053、t=4.532、Z=—8.925、Z=—6.714、Z=—7.351,均为P<0.001)。②RBT组早产儿输血后肝功能损害、支气管肺发育不良(BPD)发生率分别为25.2%(37/147)、29.3%(43/147),均高于LBT组的18.8%(22/117)、3.4%(4/117),并且差异均有统计学意义(χ^(2)=6.931、P=0.008,χ^(2)=30.785、P=0.001)。2组早产儿输血后红细胞增多症、肾功能损害、医院感染(NI)、新生儿坏死性小肠结肠炎(NEC)、脑室内出血(IVH)及早产儿视网膜病(ROP)发生率比较,差异均无统计学意义(P>0.05)。结论对早产儿贫血采取LBT策略的疗效优于RBT。
Objective To explore the therapeutic effect of restrictive transfusion(RBT)and liberal transfusion(LBT)in the treatment of premature infants with anemia.Methods From January 2015 to December 2017,a total of 264 premature infants who were diagnosed as anemia in Affiliated Hospital of Guizhou Medical University and received red blood cell transfusion(RBCT)treatment were selected as research subjects.Clinical data of them were analyzed retrospectively.According to RBCT strategies,they were divided into RBT group(n=147)and LBT group(n=117).The general clinical data,transfusion and hospitalization conditions,and incidence of blood transfusion-related diseases between two groups were statistically analyzed by independent-samples t test,chi-square test and Wilcoxon rank sum test.This study met requirements of World Medical Association Declaration of Helsinki revised in 2013.Results①Total volumes and times of RBCT,increasing levels of hemoglobin(Hb)and hematocrit(HCT)after transfusion,and duration of mechanical ventilation,parenteral nutrition time and hospitalization of premature infants in RBT group were 90.0 mL(70.0-120.0 mL),2 times(2-2 times),(63.0±21.2)g/L,(17.5±6.2)%,10 d(3-18 d),16 d(9-22 d)and 31.0 d(23.0-38.0 d),respectively,which were significantly more,higher and longer than those of 80.0 mL(62.5-110.0 mL),2 times(1-2 times),(51.9±23.2)g/L,(13.8±7.1)%,0 d(0-3 d),6 d(2-14 d)and 17.0 d(9.5-26.5 d),respectively in LBT group,and all differences were statistically significant(Z=—2.134,P=0.033;Z=—3.588,t=4.053,t=4.532,Z=—8.925,Z=—6.714,Z=—7.351,all P<0.001).②Incidences of liver function damage and bronchopulmonary dysplasia(BPD)of premature infants in RBT group after transfusion were 25.2%(37/147)and 29.3%(43/147),respectively,which were significantly higher than those of 18.8%(22/117)and 3.4%(4/117),respectively in LBT group,and all differences were statistically significant(χ^(2)=6.931,P=0.008;χ^(2)=30.785,P=0.001).There were no significant differences between two groups of premature infants a
作者
李君
陈茂琼
王榜珍
陈晓霞
Li Jun;Chen Maoqiong;Wang Bangzhen;Chen Xiaoxia(Guizhou Medical University,Guiyang 550004,Guizhou Province,China;Department of Neonatology,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou Province,China)
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2021年第2期166-170,共5页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
基金
贵州省卫健委科学技术基金项目(gzwjkj2020-1-143)。
关键词
红细胞输注
贫血
限制性输血
非限制性输血
治疗结果
婴儿
早产
Erythrocyte transfusion
Anemia
Restrictive transfusion
Liberal transfusion
Treatment outcome
Infant,premature
