新生儿换血不良结局相关因素分析.pdfVIP

赵小朋等 新生儿换血不良结局相关因素分析 第6期 · 797· 新生儿换血不良结局相关因素分析 赵小朋 宋燕燕 李 坚 叶青青 黄翠玲 林 斯 广东省广州市妇婴医院新生儿科 510180 中国图书分类号 R722 文献标识码 B 文章编号 1001-4411【2008)064)79／4)2 【摘 要】 目的：探讨新生儿换血所致各种不良结局可能相关的各种危险因素，为临床实施换血提供帮助。方法：不良结 局定义为换血7天内发生的任何一种并发症。具体包括：血小板减少症：血小板计数50×10 ／L；低钙血症：血清总钙8 mS／ dl；代谢性酸中毒：血清重碳酸氢盐16 mmo~L；低血糖：血清糖40 mg／dL；肾衰：血肌酐水平2．0 mg／dl：呼吸停止20 S； 心搏徐缓：心率80~,／min；血压过低或高血压；呼吸窘迫；抽搐。拟探讨的相关因素包括性别、胎龄、换血时体重、疾病状 态、换血日龄及换血成份。结果：换血最常见的不良反应分别是低钙血症、代谢性酸中毒和低钾血症，并多发生于早产儿。胎 龄≤32周、换血时疾病状态为导致换血后不良结局发生的独立危险因素 (P0．05)，回归系数分别为5．7l8、8．1l5，相对危险 度分别为6．28(1．77—51．32)、l1．73(3．35—41．14)。结论：换血后内环境的改变危险仍然存在，且与胎龄、体重和疾病状态 正相关，对于胎龄≤32周合并有各种严重疾病的新生儿，是否实施换血术要慎重对待。 【关键词】 新生儿 换血疗法 分析 Analyse the correlative factors in the adverse events associated with neonatal ex． change transfusion ZHAO Xiao— ，SONG Yah—Yah，LI Jian，et a1．The Maternal and Infant Hospital of Guangzhou，Cuangzhou 510180，Guangdong，China (Abstract) Objective：To investigate potential factor attributable to adverse events of neonatal exchange transfusion．Methods：56 cases records for the past 10 years from neonatal department of my hospital were reviewed retrospectively．adverse events Was defined as seri- OUS complications occurring within one week of exchange transfusion，include hypokalemia，hyperkalemia，hypocalcemia，hypoglycemia， metabolic acidosis，and thrombocytopenia，tachycardia，hypertension or hypoiension，correlative factors include sex，gestational age， weight，healthy or il1．The multiple regression analysis was used to obtain the correlation equations．Results：The common adverse events in the exchange transfusion included hypocalcium，metabolic acidosis，hypokalemia，which was observed commouly in the neonatal infants， gestational ages32 weeks，heather or ill condition was the independent risk factor，regression index was 5．7 1 8，8．1 1 5 respectively，the relative risk Was 6．28(1．77—51．32)，11．73(3．35—41．14)respectively．Conclusion