输血治疗对早产贫血患儿脑及肠道组织氧饱和度的影响
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摘要
目的:研究输血治疗对早产贫血患儿脑及肠道组织氧饱和度的影响。方法:选择本院95例早产贫血患儿作为研究对象,根据贫血程度分为轻度组30例、中度组30例、重度组35例,另选择35例无贫血早产儿作为对照组。比较4组的基础生命体征、Hb与Hct、脑及肠道组织氧饱和度。结果:4组治疗后的SBP、DBP比较,差异均无统计学意义(P>0.05);对照组、轻度组治疗后的HR、RR显著高于重度组治疗后的HR、RR,中度组治疗后的RR显著低于对照组治疗后的RR,差异均有统计学意义(P<0.05)。对照组、轻度组治疗后的Hb显著高于中度组、重度组治疗后的Hb,中度组治疗后的Hb显著高于重度组治疗后的Hb,差异均有统计学意义(P<0.05);对照组、轻度组治疗后的Hct显著高于重度组治疗后的Hct,差异均有统计学意义(P<0.05);中度组治疗后的Hct与轻度组、重度组治疗后的Hct比较,差异均无统计学意义(P>0.05)。对照组、轻度组治疗后的脑氧饱和度显著高于重度组治疗后的脑氧饱和度,对照组治疗后的肠道组织氧饱和度显著高于重度组治疗后的肠道组织氧饱和度,差异均有统计学意义(P<0.05);重度组与中度组治疗后的脑氧饱和度比较,重度组、中度组、轻度组治疗后的肠道组织氧饱和度比较,差异均无统计学意义(P>0.05)。结论:输血治疗能在不影响血压的情况下,显著提高早产贫血患儿脑及肠道组织氧饱和度,改善患儿贫血程度,可在严格把握临床指征提前下合理运用。
Objective:To study the effect of blood transfusion therapy on oxygen saturation in brain and intestinal tissues of children with premature birth and anaemia.Methods:Ninety-five children with premature birth and anaemia in our hospital from August 2016 to July 2018 were selected as subjects.According to the degree of anemia,they were divided into three groups,with 30 patients in the mild group,30 in the moderate group and 35 in the severe group.35 premature without anemia were set as the control group.Basal vital signs,Hb and Hct,brain and intestinal tissue oxygen saturation were compared among the four groups.Results:There were no significant differences in SBP and DBP between the four groups after treatment (P>0.05).The HR and RR after treatment in the control group and the mild group were significantly higher than those in the severe group.The RR was significantly lower than that of the control group,and the difference was statistically significant (P<0.05).The Hb in the control group and the mild group was significantly higher than that in the moderate group and the severe group.The Hb in the moderate group was significantly higher than that in the severe group.The difference was statistically significant (P<0.05%).Hct in the control group and the mild group was significantly higher than that in the severe group (P<0.05).The Hct in the moderate group was treated with the mild group and the severe group.After Hct comparison,the difference was not statistically significant (P>0.05).The cerebral oxygen saturation after treatment in the control group and the mild group was significantly higher than that in the severe group.The intestinal tissue oxygen saturation after treatment was significantly higher than that in the severe group.The difference was statistically significant (P<0.05).Compared with the cerebral oxygen saturation after treatment in the severe group and the moderate group,the intestinal tissue oxygen saturation after treatment in the severe group,the moderate group and the mild group,there was no significant difference in the difference (P>0.05).Conclusion:Blood transfusion therapy can significantly improve the oxygen saturation of brain and intestinal tissues in children with premature anaemia without affecting blood pressure,and improve the degree of anemia in children.It can be used reasonably in strict control of clinical indications.
Objective:To study the effect of blood transfusion therapy on oxygen saturation in brain and intestinal tissues of children with premature birth and anaemia.Methods:Ninety-five children with premature birth and anaemia in our hospital from August 2016 to July 2018 were selected as subjects.According to the degree of anemia,they were divided into three groups,with 30 patients in the mild group,30 in the moderate group and 35 in the severe group.35 premature without anemia were set as the control group.Basal vital signs,Hb and Hct,brain and intestinal tissue oxygen saturation were compared among the four groups.Results:There were no significant differences in SBP and DBP between the four groups after treatment (P>0.05).The HR and RR after treatment in the control group and the mild group were significantly higher than those in the severe group.The RR was significantly lower than that of the control group,and the difference was statistically significant (P<0.05).The Hb in the control group and the mild group was significantly higher than that in the moderate group and the severe group.The Hb in the moderate group was significantly higher than that in the severe group.The difference was statistically significant (P<0.05%).Hct in the control group and the mild group was significantly higher than that in the severe group (P<0.05).The Hct in the moderate group was treated with the mild group and the severe group.After Hct comparison,the difference was not statistically significant (P>0.05).The cerebral oxygen saturation after treatment in the control group and the mild group was significantly higher than that in the severe group.The intestinal tissue oxygen saturation after treatment was significantly higher than that in the severe group.The difference was statistically significant (P<0.05).Compared with the cerebral oxygen saturation after treatment in the severe group and the moderate group,the intestinal tissue oxygen saturation after treatment in the severe group,the moderate group and the mild group,there was no significant difference in the difference (P>0.05).Conclusion:Blood transfusion therapy can significantly improve the oxygen saturation of brain and intestinal tissues in children with premature anaemia without affecting blood pressure,and improve the degree of anemia in children.It can be used reasonably in strict control of clinical indications.
引文
1黄丽娟,臧莉莉,郝娟,等.极早产儿贫血及输血治疗对组织氧饱和度及血压的影响[J].中国现代医学杂志,2017,27(16):108-112.
2邹芸苏,杨洋,吴越,等.红细胞输注过程中早产儿肠道组织氧饱和度变化的临床研究[J].中国新生儿科杂志,2017,32(6):435-438.
3 Mccredie VA,Piva S,Santos M,et al.The impact of red blood cell transfusion on cerebral tissue oxygen saturation in severe traumatic brain injury[J].Neurocritical Care,2016,26(2):1-9.
4葛迎年,童笑梅,刘云峰.输血对贫血早产儿生命体征及心脏功能的影响[J].中国当代儿科杂志,2015,17(4):337-340.
5黄昕,滕秀飞,杨延超,等.低血红蛋白对全麻患者脑氧饱和度及术后认知功能的影响[J].中国医科大学学报,2016,45(1):35-38.
6中国医师协会检验医师分会贫血性疾病检验医学专家委员.贫血性疾病检验诊断报告模式专家共识[J].中华医学杂志,2016,96(12):930-932.
7龚晓琴,彭华保,文果,等.危重早产儿检验性失血与贫血的相关性[J].中华新生儿科杂志,2015,30(1):12-16.
8陈德兴,曹欢,张静.严重感染患者输血与否的血红蛋白浓度参考标准研究[J].中国医药导报,2016,13(8):136-139.
9李旭芳,关瑞莲,程婷婷,等.不同通气方式对肺表面活性物质治疗呼吸窘迫综合征早产儿过程中脑氧代谢的影响[J].中华实用儿科临床杂志,2017,32(2):96-99.
10 Tageldein M.Effects of blood transfusion on oxygen extraction ratio and central venous saturation in children after cardiac surgery[J].Annals of Saudi Medicine,2017,37(1):481-487.
11荣箫,周伟.早产儿贫血输血相关临床问题研究进展[J].中国新生儿科杂志,2015,30(5):379-381.
12蒋滔滔,高延,罗小杏,等.脑氧饱和度检测对脑损伤综合征婴儿脑功能的评定[J].中国儿童保健杂志,2015,23(5):460-461.
13隆维东,黄冬悦,肖剑平.输血改善贫血早产儿临床体征效果分析及机制研究[J].山西医药杂志,2016,45(9):1090-1092.
14陈青青,潘新年,江蕙芸.乳铁蛋白对34~36周早产儿贫血及反复呼吸道感染的影响[J].中国妇幼健康研究,2016,27(4):424-427.
15 Corinna BH,Berndt U,Martin K,et al.Cerebral tissue oxygen saturation is associated with N-terminal probrain natriuretic peptide in preterm infants on their first day of life[J].Acta Paediatrica,2015,104(1):32-37.
16赵娟.不同剂量重组人促红细胞生成素对早产儿脑损伤的作用研究[J].医学研究杂志,2018,47(2):107-111.
17王彤,李瑛瑜,王丽娟.应用重组人促红细胞生成素预防枸橼酸咖啡因所致早产儿贫血的效果[J].国际儿科学杂志,2016,43(9):738-739.
18 Mauriat P,Tafer N,Ouattara A.Monitoring of oxygen saturation by near-infrared spectroscopy and paediatric cardiac surgery:Not just for the brain[J].Anaesthesia Critical Care&Pain Medicine,2015,34(5):257-258.
2邹芸苏,杨洋,吴越,等.红细胞输注过程中早产儿肠道组织氧饱和度变化的临床研究[J].中国新生儿科杂志,2017,32(6):435-438.
3 Mccredie VA,Piva S,Santos M,et al.The impact of red blood cell transfusion on cerebral tissue oxygen saturation in severe traumatic brain injury[J].Neurocritical Care,2016,26(2):1-9.
4葛迎年,童笑梅,刘云峰.输血对贫血早产儿生命体征及心脏功能的影响[J].中国当代儿科杂志,2015,17(4):337-340.
5黄昕,滕秀飞,杨延超,等.低血红蛋白对全麻患者脑氧饱和度及术后认知功能的影响[J].中国医科大学学报,2016,45(1):35-38.
6中国医师协会检验医师分会贫血性疾病检验医学专家委员.贫血性疾病检验诊断报告模式专家共识[J].中华医学杂志,2016,96(12):930-932.
7龚晓琴,彭华保,文果,等.危重早产儿检验性失血与贫血的相关性[J].中华新生儿科杂志,2015,30(1):12-16.
8陈德兴,曹欢,张静.严重感染患者输血与否的血红蛋白浓度参考标准研究[J].中国医药导报,2016,13(8):136-139.
9李旭芳,关瑞莲,程婷婷,等.不同通气方式对肺表面活性物质治疗呼吸窘迫综合征早产儿过程中脑氧代谢的影响[J].中华实用儿科临床杂志,2017,32(2):96-99.
10 Tageldein M.Effects of blood transfusion on oxygen extraction ratio and central venous saturation in children after cardiac surgery[J].Annals of Saudi Medicine,2017,37(1):481-487.
11荣箫,周伟.早产儿贫血输血相关临床问题研究进展[J].中国新生儿科杂志,2015,30(5):379-381.
12蒋滔滔,高延,罗小杏,等.脑氧饱和度检测对脑损伤综合征婴儿脑功能的评定[J].中国儿童保健杂志,2015,23(5):460-461.
13隆维东,黄冬悦,肖剑平.输血改善贫血早产儿临床体征效果分析及机制研究[J].山西医药杂志,2016,45(9):1090-1092.
14陈青青,潘新年,江蕙芸.乳铁蛋白对34~36周早产儿贫血及反复呼吸道感染的影响[J].中国妇幼健康研究,2016,27(4):424-427.
15 Corinna BH,Berndt U,Martin K,et al.Cerebral tissue oxygen saturation is associated with N-terminal probrain natriuretic peptide in preterm infants on their first day of life[J].Acta Paediatrica,2015,104(1):32-37.
16赵娟.不同剂量重组人促红细胞生成素对早产儿脑损伤的作用研究[J].医学研究杂志,2018,47(2):107-111.
17王彤,李瑛瑜,王丽娟.应用重组人促红细胞生成素预防枸橼酸咖啡因所致早产儿贫血的效果[J].国际儿科学杂志,2016,43(9):738-739.
18 Mauriat P,Tafer N,Ouattara A.Monitoring of oxygen saturation by near-infrared spectroscopy and paediatric cardiac surgery:Not just for the brain[J].Anaesthesia Critical Care&Pain Medicine,2015,34(5):257-258.