输血对贫血早产儿生命体征及心脏功能的影响

Effects of blood transfusion on vital signs and heart function in preterm infants with anemia

摘要:

目的 探讨输血对贫血早产儿生命体征及心脏功能的影响。方法 采用前瞻性队列研究方法,以胎龄<34 周、出生1 周后接受输血治疗的40 例贫血早产儿为研究对象。运用便携式超声诊断仪测定输血前与输血结束后24 h 内左心室射血分数、短轴缩短率、每搏输出量、心输出量。输血前后各24 h 内记录患儿有无呼吸暂停及呼吸暂停次数;输血前及输血结束时,在患儿安静时监测一次体温、血压,同时输血前后各4 h 内每小时记录一次患儿安静时的心率、呼吸频率、经皮氧饱和度等。结果 与输血前比较,输血后4 h 内患儿心率、呼吸频率均明显下降(P<0.05)。4 例患儿输血前24 h 内有呼吸暂停,输血后24 h 内未再出现呼吸暂停。输血后收缩压、舒张压、平均动脉压、体温较前均无显著变化(P>0.05);输血后左心室射血分数、每搏输出量、心输出量、短轴缩短率较前均无显著变化(P>0.05)。结论 输血可以改善贫血早产儿的临床症状,而且对心脏功能无显著影响。

Abstract:

Objective To explore the effects of blood transfusion on the vital signs and heart function in preterm infants with anemia. Methods A total of 40 anemic preterm infants with gestational age less than 34 weeks who accepted blood transfusion one week after birth were enrolled for a prospective cohort study. Left ventricular ejection fraction (LVEF), fractional shortening (FS), stroke volume (SV), and cardiac output (CO) were determined with portable ultrasonic equipment before blood transfusion and within 24 hours after blood transfusion. Apnea was detected and the times of apnea were recorded within 24 hours before and after blood transfusion. The resting body temperature and blood pressure were also determined before and after blood transfusion. Additionally the resting heart rate, respiratory rate, and transcutaneous oxygen saturation were recorded within 4 hours before and after blood transfusion. Results The heart rate and respiratory rate decreased significantly within 4 hours after blood transfusion (P<0.05). Four infants had apnea within 24 hours before blood transfusion, and nobody had apnea within 24 hours after blood transfusion. The systolic pressure, diastolic pressure, mean arterial pressure, and body temperature showed no significant changes after blood transfusion (P>0.05), and the LVEF, SV, CO, and FS showed no significant changes after blood transfusion as well (P>0.05). Conclusions Blood transfusion can improve the clinical symptoms and shows no significant effect on the heart function in preterm infants with anemia.