The Study Of The Effect Of Umbilical Cord Blood Test On The Clinical Management Of Very Low Birth Weight Infants

1.Background and Objection1.1 BackgroundVery low birth weight infants(VLBWI)are a kind of neonates whose birth weight are less than 1500g.Iatrogenic blood loss is one of the main causes of anemia and the highest blood transfusion rate can reach 70%.Although blood transfusion is the most effective method to correct anemia,it may be related to bronchopulmonary dysplasia and other diseases.At present,relevant studies have proved that umbilical cord blood can be used for the whole blood cell count,blood culture and blood gas examination on admission,which is one of the methods to reduce iatrogenic blood loss.1.2 ObjectionThe purpose of this study is to evaluate the effect of blood sampling from the umbilical cord compared with initial blood sampling from neonates on iatrogenic blood loss,hemoglobin,hematocrit,blood transfusion and complications during hospitalization,so as to provide better diagnosis and treatment ideas for clinical physicians and open up clinical thinking.2.Materials and methods2.1 Research objectThe preterm infants with birth weight less than 1500g hospitalized in neonatal intensive care unit(NICU)from October 2019 to September 2020 were selected.The age of admission was within the first day after birth.2.2 MethodsThe patients were divided into the experimental group(n=117)and the control group(n=104)according to whether umbilical cord blood samples were used for the admission examination.The iatrogenic blood loss,hemoglobin content and hematocrit were recorded on the first day,the third day,the seventh day,the fourteenth day and the 21st day after birth.Analyze whether there are differences between the experimental group and the control group on the incidence of blood transfusion,the time of the first blood transfusion,the number of blood transfusion and the total blood transfusion volume.Analyse whether there are differences on the blood pressure,patent ductus arteriosus,neonatal respiratory distress syndrome,neonatal necrotizing enterocolitis,bronchopulmonary dysplasia,intraventricular hemorrhage,sepsis,retinopathy of prematurity,duration of ventilator-assisted ventilation,duration of intravenous nutrition,volume expansion,and the use of vasoactive drugs within 24 hours.3.Research results3.1 The amount of iatrogenic blood loss in each groupOn the 1st,3rd,7th,14th and 21st day after birth,the iatrogenic blood loss of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).3.2 The content of hemoglobin and hematocrit in each groupOn the third day after birth,the hemoglobin M(P25,P75)and hematocrit of the experimental group were 163.0(151.5-178.5)g/L and 49.8%respectively,while those of the control group were 155.0(140.0-168.0)g/L and 47.9%respectively.The differences between the two groups were statistically significant(P=0.004 and 0.027,respectively).On the 1st,7th and 14th day after birth,there was no significant difference in hemoglobin and hematocrit between the two groups.3.3 Blood transfusion of preterm infants in each groupThere was no significant difference between the blood transfusion rate,the time of first blood transfusion,the total amount of blood transfusion,the number of blood transfusion and the blood transfusion rate within 1 week and 2 weeks between the experimental group and the control group.The blood transfusion rate within 3 weeks of the experimental group was 17.1%,and that of the control group was 28.8%.There was a statistical difference between the two groups(P=0.037).3.4 The complications of preterm infants in each groupThe duration of parenteral nutrition M(P25,P75)was 27(21.8-34.5)days in the experimental group and 31(23.3-46)days in the control group(P=0.035).There was no significant difference in volume expansion,vasoactive drug use,intracranial hemorrhage,bronchopulmonary dysplasia,neonatal respiratory distress syndrome,neonatal necrotizing enterocolitis,early-onset sepsis,late-onset sepsis,incidence of retinopathy of prematurity and the length of hospital stay between the two groups.4.Conclusion4.1 Using umbilical cord blood samples to complete the admission examination can reduce the amount of iatrogenic blood loss.4.2 The use of umbilical cord blood samples to complete the admission examination can improve the hemoglobin and hematocrit on the 3rd day after birth,but has no effect 3 day later after birth.4.3 Using umbilical cord blood samples to complete the admission examination has no effect on the blood transfusion rate,the time of the first blood transfusion and the total amount of blood transfusion,but it can reduce the proportion of neonates who need blood transfusion within 3 weeks.4.4 Using umbilical cord blood samples to complete the admission examination can reduce parenteral nutrition time,but has no effect on patent ductus arteriosus,the volume expansion,vasoactive drug use,intracranial hemorrhage,bronchopulmonary dysplasia,neonatal respiratory distress syndrome,neonatal necrotizing enterocolitis,early-onset sepsis,late-onset sepsis,incidence of retinopathy of prematurity and the duration of stay.