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Clinical Analysis Of Transfusion-related Necrotizing Enterocolitis In Preterm Infants

Posted on:2019-05-27Degree:MasterType:Thesis
Country:ChinaCandidate:Z M LiFull Text:PDF
GTID:2394330566490244Subject:pediatrics
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ObjectiveTo investigate the clinical features and prognosis of TA-NEC(Transfusion Associated Necrotizing Enterocolitis,TA-NEC),clinical data of Necrotizing Enterocolitis(NEC)in preterm infants were retrospectively analyzed.MethodsClinical data of preterm infants with NEC from January 2013 to June 2017 was retrospective analyzed.Patients with NEC were divided into two groups:transfusion-associated NEC group(patients with a prior history of blood transfusion within 48 hours of onset of NEC)and non–transfusion-associated NEC group(patients without transfusion history within 48 hours of onset of NEC).Clinical characteristics,blood transfusion factors were compared between the two groups,along with clinical outcomes and prognosis of the two groups.ResultsAmong the total investigated 2775 premature infants during the study period,there were 46 patients(1.66%)who had developed NEC.The average birth weight was 1431.52 ± 476.03 g and average gestational age was 30.96 ± 2.45 weeks.The rate of surgery and mortality was 34.78% and 19.56%.There were twelve cases of transfusion-associated NEC group accounting for 26% of the total 46 cases of NEC(12/46).The gestational age(GA)and birth weight(BW)of transfusion-associated NEC group were significantly lower than the non–transfusion-associated NEC group(GA 29.26±0.38/31.55±0.42 w,BW 1200±58.17/1513.24±86.78g).While the age of onset was later in the transfusion-associated NEC group compared with the non–transfusion-associated NEC group(28.67±6.65/17.03±9.90d).Hemoglobin and hematocrit of the transfusion-associated NEC group before the onset of NEC were lower than non-transfusion-associated NEC group(93.83±6.81 g vs 119.18±27.39g;28.69±3.59% vs 34.72±7.39 %;P<0.05).Conditions were relatively stable in the transfusion-associated NEC group before onset of NEC which were completly enteral feeding and without mechanical ventilation.There were no significant differences in gestational age,history of asphyxia,intrauterine growth restriction,maternal age and complications during pregnancy,sex and mode of production,patent ductus arteriosus,septicemia,bronchopulmonary dysplasia,retinopathy and intraventricular hemorrhage between the two groups.The transfusion-associated NEC group developed presenting signs within 16.5±10.94 hours of a PRBC transfusion(p < 0.05).In contrast,thenon-transfusion-associated NEC group had onset of NEC after 209.11±130.29 hours of a transfusion.Comparation between the two groups also showed that no significant difference in red blood type,number of transfusion times,storage time of the blood,whether from the same donor and whether irradiation before transfusion.There were no significant difference in clinical manifestation and prognosis between the two groups.ConclusionCompared with non-transfusion-associated NEC group,TA-NEC group were more often suffered in smaller gestational age,lower birth weight preterm infants.The age of onset of TA-NEC was more later with lower hemoglobin and hematocrit than non TA-NEC.But independent association among anaemia,blood transfusion and NEC still need further investigation.
Keywords/Search Tags:Red blood transfusion, Necrotizing enterocolitis, preterm, anemia
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