| Objective: To understand the current situation and related factors of newborn blood transfusion,accumulate experience and provide clinical data for newborn blood transfusion.Methods: The clinical data of 271 newborns treated by blood transfusion from November 1,2016 to May 15,2018 in the Neonatal Department of the First Affiliated Hospital of Guangxi Medical University were collected.The results of gender,gestational age,birth weight,hospital stay,blood transfusion,disease and laboratory examination were retrospectively analyzed,and SPSS24.0 software was used for statistical analysis.Results:(1)2649 newborns were hospitalized in the same period,348 of them received blood transfusion,with a blood transfusion rate of 13.1%.Excluding 77 cases that met the exclusion criteria,271 blood transfusion cases were collected,with a red blood cell transfusion rate of 9.9%,a plasma transfusion rate of 3.5%,and a platelet transfusion rate of 0.8%.(2)The main diagnosis of blood transfusion patients discharged from hospital was premature infant(15.7%),neonatal hyperbilirubinemia(15.5%)and neonatal pneumonia(11.4%).Neonatal anemia(55.4%)and neonatal pneumonia(29.2%)were themost frequent complications.Intracranial hemorrhage accounted for 23.6%during hospitalization,followed by retinopathy of prematurity(8.1%).(3)There is a significant difference in the number of blood transfusions between premature infants and term infants,with a P value of 0.000.It is suggested that the number of blood transfusions in premature infants is significantly higher than that in term infants.The correlation analysis of the number of blood transfusions with birth weight and gestational age showed that the P values were0.000 and 0.000 respectively,suggesting that the larger the birth weight and gestational age,the less the number of blood transfusions,and the difference was statistically significant.(4)in 223 anemic newborns,HGB was < 110 g/l before transfusion in most newborns,and the average HGB was about 88g/L before transfusion.32.9% of the children suffered from anemia due to blood loss(iatrogenic,umbilical cord rupture,other),followed by erythropoietic destruction(infection,hereditary anemia,erythrocyte membrane)and hemolysis(immune,mechanical),accounting for 27.9% and 7.0% respectively.Platelet transfusion was performed in 21 neonates.PLT counts before transfusion were mostly in the range of 10-30×109/L,which was common in thrombocytopenia.Plasma transfusion was performed in 91 neonates,mainly concentrated in premature infants,infectious diseases and hemorrhagic diseases.APTT>65s >65s in most infants before blood transfusion.(5)Thirty-two children underwent exchange transfusion via peripheral artery and vein.The exchange rate of serum total bilirubin was 49.5%.The major cause of severe hyperbilirubinemia was G6 PD deficiency,with a total of 18 cases(56.3%),followed by 10 cases(31.3%)of maternal and infant blood group incompatibility.After exchange transfusion,the total bilirubin and direct bilirubin in serum decreased significantly,P<0.05,with statistical significance.Conclusion:(1)The blood transfusion rate in the department of neonatology in our hospital in the past year and a half is 13.1%,among which the red blood cell blood transfusion rate is 9.9%,the plasma blood transfusion rate is 3.5%,and the platelet blood transfusion rate is 0.8%.(2)The diseases of children with blood transfusion are mainly premature infants,neonatal hyperbilirubinemia and neonatal pneumonia.(3)The number of blood transfusions in preterm infants is significantly higher than that in term infants.The larger the gestational age and birth weight,the less the number of blood transfusions in preterm infants.(4)The major diseases of severe hyperbilirubinemia requiring exchange transfusion are G6 PD deficiency and maternal-infant blood type incompatibility.Exchange transfusion is an effective method to treat severe neonatal hyperbilirubinemia. |
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