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目的探讨危重早产儿检验性失血与贫血的相关性。方法选择2012年4月至2013年4月我院新生儿重症监护室(NICU)收治的危重早产儿,统计住院期间失血及贫血情况,比较不同胎龄、不同出生体重早产儿贫血比例及首次贫血时间。将住院前4周分贫血组与无贫血组,排除输血因素,对两组每周的血红蛋白差值(ΔHb)与其检验性失血量进行相关性评估,并对早产儿贫血进行单因素及多因素分析。结果共纳入分析246例,其中贫血188例,贫血比例76.4%(188/246),贫血均发生在住院前4周内,以前2周为著,占88.3%(166/188)。胎龄越小、出生体重越低,贫血发生时间越早,贫血比例越高。住院前2周内检验性失血量与ΔHb关系密切,呈显著正相关,第3、4周检验性失血与贫血无明显相关性。单因素分析显示,住院前2周失血量、胎龄、出生体重、住院天数、初始Hb值与贫血有关;Logistic回归分析显示,住院天数及前2周累积采血量≥7.5 ml/kg是危重早产儿贫血的独立危险因素(P<0.05),其中前2周采血量>15 ml/kg致贫血的危险性是采血量7.5~15 ml/kg的2.10倍。结论检验性失血与危重早产儿贫血密切相关,前2周累积采血量≥7.5 ml/kg是引发危重早产儿贫血的危险因素,采血量越多,贫血几率越大,贫血程度越重。
Objective To explore the correlation between test-induced blood loss and anemia in critically ill preterm infants. Methods From April 2012 to April 2013, our hospital neonatal intensive care unit (NICU) admitted to critically ill preterm infants, statistics of blood loss and anemia during hospitalization, compared with different gestational age, different birth weight and anemia in preterm infants and first anemia time. Four weeks before hospitalization, patients with anemia and anemia were excluded, and the factors of blood transfusion were excluded. The weekly hemoglobin difference (ΔHb) between the two groups was assessed by correlation with the test blood loss. Single and multifactorial factors analysis. Results A total of 246 cases were included in the analysis, including 188 cases of anemia and 76.4% of patients with anemia (188/246). Anemia occurred within 4 weeks before hospitalization, 88.3% (166/188) of the previous 2 weeks. The smaller the gestational age, the lower the birth weight, the earlier the anemia occurs and the higher the proportion of anemia. There was a significant positive correlation between blood loss and ΔHb in the two weeks before hospitalization. There was no significant correlation between blood loss and anemia in the third and fourth weeks. Univariate analysis showed that blood loss, gestational age, birth weight, length of hospital stay, and initial Hb were associated with anemia in the first 2 weeks of hospitalization. Logistic regression analysis showed that hospitalization days and accumulated blood volume in the first 2 weeks of ≥7.5 ml / kg were critically preterm births (P <0.05). Among them, the risk of anemia in the first two weeks when blood volume was> 15 ml / kg was 2.10 times higher than the blood volume 7.5 ~ 15 ml / kg. Conclusions The test-induced blood loss is closely related to the risk of anemia in critically ill preterm infants. The accumulated blood volume in the first two weeks of ≥7.5 ml / kg is a risk factor for the development of anemia in critically ill preterm infants. The greater the blood volume, the greater the anemia and the more severe the anemia.