目的 探讨极低出生体重儿贫血的发生时间及影响因素,为临床诊治提供参考依据。方法 收集2012年1月-2013年12月本院收治的147例极低出生体重儿(very low birth weight infants,VLBWI)的临床资料数据,根据贫血发生时间分为4组,对每组患儿相关临床资料进行分析。结果 147例VLBWI临床诊断贫血的平均日龄为(12.26±7.95) d,其中早期贫血发生者44例(29.9%),晚期贫血发生者103例(70.1%)。4组VLBWI分别在新生儿期累积采血量、累积输血量、基础血红蛋白及基础平均红细胞压积方面差异有高度统计学意义(P＜0.01);同时各组患儿在胎盘早剥、宫内窘迫、新生儿颅内出血等围产因素的比较差异有统计学意义(P＜0.05)。多因素Logistic回归分析,早期医源性失血及基础血红蛋白与贫血早期发生的关系更为密切。结论 贫血是VLBWI生后常见并发症。早期医源性失血及基础Hb水平是导致贫血早发的高危因素,多种围生期因素可影响贫血发生时间,目前输血治疗仍是治疗VLBWI贫血的常规甚至是首选方法 。
Abstract
Objective To explore the anemia onset time and influencing factors in very low birth weight infants(VLBWI).Methods A total of 147 VLBWI hospitalized in neonatal ward of affiliated hospital of Qingdao University from January 2012 to December 2013 were divided into 4 groups according to the anemia time.The perinatal factors with the anemia were analysed respectively in the groups. Results The average time for onset of anemia was (12.26±7.95)d.The incidences of early anemia was 29.9%,the late anemia was 70.1%.Compared with each other of the four VLBWI groups,accumulation of blood loss and the amount of blood transfusion within 4 weeks after birth in VLBWI had statistically significant differences(P＜0.01).Compared with each other groups,the level of initial hemoglobin and the initial HCT of VLBWI had statistically significant differences(P＜0.01).The differences in the following aspects:placental abruption,fetal distress,intracranial hemonhage of the newborn (ICH),complications during neoynatal stage were statistically significant (P＜0.05).Logistic analysis showed that the latrogenic blood loss and the level of Hb related with anemia.Conclusion s Anemia is a common complication in the VLBWI.The latrogenic blood loss and the level of Hb are important high risk factors of the occurrence of anemia.Blood transfusion is the routine even the preferred method to cure anemia in VLBWI.
关键词
极低出生体重儿 /
贫血 /
医源性失血 /
输血
Key words
very low birth weight /
anemia /
latrogenic blood loss /
transfusion
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