新生儿输血相关坏死性小肠结肠炎危险因素分析

中国小儿急救医学 Pub Date : 2020-02-20 DOI:10.3760/CMA.J.ISSN.1673-4912.2020.02.013

Li-jun Liu, Xuemei Yang

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引用次数: 0

摘要

目的探讨输血相关性坏死性小肠结肠炎(TANEC)的临床相关因素，以降低新生儿坏死性小肠结肠炎(NEC)的发病率。方法收集2017年1月至2018年6月兰州大学第一医院住院并接受输血治疗的新生儿的临床资料，包括围生期因素、患儿基本情况及合并症。根据输血后48小时内有无NEC的发生分为TANEC组和无TANEC组。比较两组患者的临床资料。结果单因素分析显示，分娩方式、胎龄、出生体重、新生儿脓毒症、动脉导管未闭(PDA)、新生儿呼吸窘迫综合征(NRDS)、贫血等差异均有统计学意义(P<0.05)。logistic多因素分析显示，胎龄(P<0.05, OR=0.772, 95%CI: 0.684 ~ 0.871)、出生体重(P<0.05, OR=0.236, 95%CI: 0.079 ~ 0.711)、贫血程度(模式1:P<0.05, OR=3.129, 95%CI: 1.003 ~ 9.756;模式2:P<0.05, OR=3.449, 95%CI: 1.024 ~ 11.609)和脓毒症(模式1:P<0.05, OR=6.327, 95%CI: 1.732 ~ 23.720;模式2:P<0.05, OR=8.154, 95%CI: 2.122 ~ 31.336)是TANEC的显著危险因素。结论导致TANEC发生的因素是多种多样的。当输血时，胎龄越大，出生体重越高，发生NEC的风险越低。新生儿败血症和贫血合并越严重，发生TANEC的风险越高。临床应采取综合措施预防新生儿贫血。根据患儿的具体情况及贫血程度，制定合理的临床策略，避免输血，以降低TANEC的发生率，改善患儿预后。关键词:新生儿;贫血;输血;输血相关的坏死性小肠结肠炎;脓毒症

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Analysis of risk factors for neonatal transfusion-associated necrotizing enterocolitis

Objective To investigate the clinical relevant factors associated with transfusion associated necrotizing enterocolitis (TANEC) in order to reduce the incidence of neonatal necrotizing enterocolitis (NEC). Methods The clinical data of neonates admitted to the First Hospital of Lanzhou University and received blood transfusion therapy from January 2017 to June 2018 were collected, including perinatal factors, basic conditions of children, and comorbidities.According to the occurrence or absence of NEC within 48 hours after transfusion, the patients were divided into TANEC group and no-TANEC group.The clinical data of the two groups were compared. Results Univariate analysis showed that there were statistical differences (P<0.05) in the mode of delivery, gestational age, birth weight, neonatal sepsis, patent ductus arteriosus(PDA), neonatal respiratory distress syndrome (NRDS), and anemia.The logistic multivariate analysis revealed that gestational age(P<0.05, OR=0.772, 95%CI: 0.684-0.871), the birth weight(P<0.05, OR=0.236, 95%CI: 0.079-0.711)were protect fators of TANEC, the degree of anemia(mode 1: P<0.05, OR=3.129, 95%CI: 1.003-9.756; mode 2: P<0.05, OR=3.449, 95%CI: 1.024-11.609)and sepsis (mode 1: P<0.05, OR=6.327, 95%CI: 1.732-23.720; mode 2: P<0.05, OR=8.154, 95%CI: 2.122-31.336)were significant risk fators for TANEC. Conclusion The factors leading to the occurrence of TANEC are various.When transfused, the greater the gestational age, the higher the birth weight, the lower the risk of developing NEC.The more severe the combination of neonatal sepsis and anemia, the higher the risk of developing TANEC.Clinically, comprehensive measures should be taken to prevent neonatal anemia.According to the specific conditions of the children and the degree of anemia, a reasonable clinical strategy should be formulated to avoid blood transfusion to reduce the incidence of TANEC and improve the prognosis of the children. Key words: Neonate; Anemia; Blood transfusion; Transfusion-associated necrotizing enterocolitis; Sepsis

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来源期刊

中国小儿急救医学

自引率

0.00%

发文量

6226

期刊介绍： Chinese Journal of Neurology was established in 1955, the predecessor of which is Chinese Journal of Neurology and Psychiatry. Chinese Journal of Neurology and Psychiatry has been indexed by MEDLINE until 1996, when it was divided into two journals, Chinese Journal of Neurology, and Chinese Journal of Psychiatry. Chinese Journal of Neurology is now indexed by EM, SCOPUS, AJ, WPRIM, CNKI, Wanfang Data, CSCD, etc. The impact factor of the journal is 2.755 in 2017, ranking the first among all neurological and psychological journals in China and among all the 142 medical journals published by the Chinese Medical Association. The journal is available both in print and online.