CAJ | 학술논문

目的观察不同输血指征对早产儿贫血及其他合并症治疗的意义,以期探讨适合我国的较为合理的输血指征.方法回顾性分析96例出生体重＜1500 g,住院时间≥2周,并接受过输血治疗的早产儿临床资料.按不同的输血指征将其分为两组,即观察1组(输血指征严格)和观察2组(输血指征宽松),其中观察1组54例,观察2组42例.观察患儿输血总量和输血次数.结果观察1组接受的总输血量比观察2组明显增高[中位值(P25,P75)为71.0(43.25,107.25) ml对 36.0(29.50,56.25)ml,P=0.001],且输血次数较观察2组增多[3.00(2.00,4.00)次对 1.50(1.00,2.25)次,P<0.01].观察1组机械通气时间及持续正压通气时间高于观察2组,但吸氧时间差异无统计学意义.观察1组患儿在颅内出血、真菌感染率及病死率上均高于观察2组(P<0.05).结论早产儿贫血易促使其并发症的发生,对早产儿存活的影响较大,结合具体病情适当放宽输血指征,科学合理用血,对早产儿的生存有积极意义.
목적 관찰불동수혈지정대조산인빈혈급기타합병증치료적의의,이기탐토괄합아국적교위합리적수혈지정.방법 회고성분석96례출생체중＜1500 g,주원시간≥2주,병접수과수혈치료적조산인림상자료.안불동적수혈지정장기분위량조,즉관찰1조(수혈지정엄격)화관찰2조(수혈지정관송),기중관찰1조54례,관찰2조42례.관찰환인수혈총량화수혈차수.결과 관찰1조접수적총수혈량비관찰2조명현증고[중위치(P25,P75)위71.0(43.25,107.25) ml대 36.0(29.50,56.25)ml,P=0.001],차수혈차수교관찰2조증다[3.00(2.00,4.00)차대 1.50(1.00,2.25)차,P<0.01].관찰1조궤계통기시간급지속정압통기시간고우관찰2조,단흡양시간차이무통계학의의.관찰1조환인재로내출혈、진균감염솔급병사솔상균고우관찰2조(P<0.05).결론 조산인빈혈역촉사기병발증적발생,대조산인존활적영향교대,결합구체병정괄당방관수혈지정,과학합리용혈,대조산인적생존유적겁의의.
Objective To compare the effect of different indications of blood transfusion on the treatment and complications in anemia of prematurity, and to investigate the suitable and reasonable indication of blood transfusion for our country. Methods Ninety six hospitalized premature infants with birth weight less than 1500g and stay in hospital equal or more than 2 weeks were enrolled in the retrospective study and divided into two groups according to different indications of blood transfusion. There are 54 cases in observation group 1 (with strict indications for transfusion) and 42 cases in observation group 2 (with loose indications for transfusion). Results In the observation group 1, the total amount of blood transfusion [M(P25,P75):71.0(43.25,107.25)ml] and the times of blood transfusion [3.00 (2.00,4.00) times] are both higher than those of the observation group 2 [36.0(29.50,56.25)ml and 1.50 (1.00,2.25) times, respectively, P=0.001]. The days of echanical ventilation and the days of continuous positive airway pressure were more in the observation group 1, but oxygen supplement in the two groups had no significant difference. In observation group 1, the incidence of intracranial hemorrhage, fungal nfection rate and mortality were higher than those of the observation group 2 (P＜0.05). Conclusions Anemia of prematurity easily led to the complications, and had obvious influence on the survival of premature infants. Clinician should consider concrete conditions of every patient before blood transfusion. It has positive significance on the survival of premature infants to loosen the indication properly and make the use of blood scientifically and rationally.