再生障碍性贫血患儿临床特征和护理

目的研究再生障碍性贫血(aplastic anemia,AA)患儿的特点,为临床护理工作提供理论依据。方法 2016年9月,回顾性分析2004年2月至2014年3月期间在中国医学科学院血液学研究所血液病医院初治的AA患者604例的临床资料。以245例AA患儿为研究组,以359例成人AA患者为对照组。比较两组患者在铁蛋白(serum ferritin,SF)、血红蛋白(hemoglobin,HB)、叶酸(folic acid,FA)、维生素B12(Vitamin B12,VB12)、白蛋白(albumin,ALB)、总铁结合力(total iron binding capacity,TIBC)、体质量指数(body mass index,BMI)及地域分布、性别、诊断间的差异。研究儿童患者血清铁蛋白分布情况,分析儿童患者营养不良的危险因素。结果儿童与成人AA患者相比,SF分别为(571.61±492.63)μg/L和(390.47±427.75)μg/L,差异有统计学意义(P0.01),FA分别为(15.28±9.08)nmol/L和(13.71±7.69)nmol/L,差异有统计学意义(P0.05)。BMI值偏低患者在儿童及成人中的比率分别为42.45%和9.75%,差异有统计学意义(P0.01)。SF在儿童重型再障(severe aplastic anemia,SAA)和非重型再障(non-evere aplastic anemia,NSAA)中分别为(457.08±471.29)μg/L和(247.85±265.96)μg/L,差异有统计学意义(P0.01)。AA患儿发生营养不良的独立危险因素为年龄(P0.01)。结论AA患儿存在特殊的临床特征和护理要点,低龄患儿更容易发生营养不良,应尽早营养教育和膳食指导。

The Clinical Features and Nursing Care of Children with Aplastic Anemia

Objective To study the characteristics of children with aplastic anemia (AA),and to provide a theoretical basis for clinical nursing work.Methods A retrospective analysis of 604 patients with AA was carried out.245 cases of children with aplastic anemia patients was study group,359 cases of adult aplastic anemia patients was the control group.The differences of serum ferritin (SF),hemoglobin (HB),folic acid (FA),Vitamin B12 (VB12),albumin (ALB),body mass index (BMI),total iron binding capacity (TIBC) and the regional distribution,gender,diagnosis were compared between the two groups.The distribution of serum ferritin and the risk factors of malnutrition in children was analyzed.Results Compared to the patients of aplastic anemia in children and adults,SF values were (571.61± 492.63) μg/L and (390.47±427.75) μg/L respectively,the difference was statistically significance (P＜0.01).FA values were (15.28± 9.08) nmol/L and (13.71 ± 7.69) nmol/L respectively,the difference was statistically significant (P＜0.05).The ratios of the lower BMI in children and adults were 42.45％ and 9.75％,respectively,and the difference was statistically significant (P ＜0.01).SF in children with severe aplastic anemia (SAA)and non-evere aplastic anemia (NSAA) were (457.08 ± 471.29) μg/L and (247.85 ± 265.96) μg/L,the difference was statistically significant (P ＜0.01).Age was the independent risk factors of malnutrition in children with aplastic anemia (P ＜0.01).Conclusion Special clinical features and nursing points exist in children with aplastic anemia patients.Young children are more likely to cause the malnutrition,which should require early nutrition education and dietary guidance.