限制性输血与非限制性输血对贫血极低出生体重早产儿病情预后的影响

目的观察限制性输血与非限制性输血对贫血极低出生体重早产儿病情预后的影响，为早产儿贫血合理输血提供一定的临床依据。方法，对86例贫血的极低出生体重早产儿诊治的临床资料进行回顾性分析，按其首次输血前的具体病情及输血的红细胞压积（Hot）数值分为限制性输血组（44例）和非限制性输血组（42例）。记录患儿输血情况：每次输血前血Hot、每次输血量、总的输血量、输血次数。比较两组患儿治疗恢复及并发症发生情况。结果限制性输血组每人总输血量明显高于非限制性输血组（t=19．82，P〈0．01），每人输血次数明显多于非限制性输血组（t=3．52，P〈0．01）；限制性输血组患儿在吸氧时间、无创持续气道正压通气（NCPAP）时间上明显高于非限制性输血组（t=5．53，2．95，P〈0．01），机械通气使用时间长于非限制性输血组（t=2．42，P〈0．05）；限制性输血组颅内出血例数、院内感染发生例数高于非限制性输血组（χ2=4．36，4．95，P〈0．05）。结论采用非限制性输血策略能及时纠正贫血，既能缩短患儿呼吸机辅助通气时间及吸氧时间，又可降低院内感染及颅内出血等并发症，有利于病情好转与康复。输血时要权衡利弊，结合患儿病情进行科学合理用血。

The effect of the restrictive transfusion and non-restrictive transfusion on clinical outcome of very low birth weight （VLBW） premature infants with anemia disease

Objective To investigate the effect of the restrictive transfusion and non-restrictive transfusion on clinical outcome of very low birth weight premature infants with anemia disease, to provide some clinical basis for reasonable transfusion in premature infants with anemia disease. Methods The clinical data of 86 cases of anemia in very low birth weight premature infants were analyzed retrospectively. They were divided into two groups according to their specific conditions and hematocrit （Hct） values before the first blood transfusion ： 44 eases in group of restrictive transfusion, and the other 42 cases of non-restrictive transfusion. The contents in each child, each Hct values before transfusion, per volume of blood trans- fusion, and the total amount and times of transfusions were recorded. The recovery and the incidence of complications were compared, respectively. Results The total amount of blood transfusion and the times of transfusions in group of restrictive transfusion were significantly higher than group of non-restrictive transfu- sion （ t = 19. 82,3.52, P 〈0. 01 ）. The same trend was also observed in the time of oxygen uptake and non-invasive continuous positive airway pressure （NCPAP） （ t = 5. 32,2. 95, P 〈 0. 01 ）. The time of mechanical ventilation in restrictive transfusion group was longer than non-restrictive transfusion group （ t = 2.42, P 〈 0. 05 ）. The cases of intracranial hemorrhage and nosocomial infection in restrictive transfusion group were higher than non-restrictive transfusion group （χ2 = 4. 36,4. 95, P 〈 0.05 ）. Conclusions The use of the strategy of non-restrictive transfusion could treat anemia of very low birth weight premature infants timly, not only short the time of mechanical ventilation and oxygen uptake, but also reduce the cases of nos- ocomial infection, intracranial hemorrhage and other complications, which would help the improvement and rehabilitation of diseases. Blood transfusion should weigh, personalized transfusion principle would be helpful for seientifie and rational use of blood.