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Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2017; 16: 13-20

Эффективность профилактики и лечения ранней анемии недоношенных у новорожденных детей, родившихся с экстремально низкой и очень низкой массой тела

Шарафутдинова Д.Р. , Балашова Е.Н. , Павлович С.В. , Ионов О. В., Киртбая А.Р. , Ленюшкина А.А. , Зубков В.В. , Дегтярёв Д. Н.

https://doi.org/10.24287/1726-1708-2017-16-4-13-20

Аннотация

На основании данных литературы и собственного опыта рассмотрены принципы лечения и профилактики ранней анемии недоношенных у детей с очень низкой массой тела (ОНМТ) и экстремально низкой массой тела (ЭНМТ) при рождении. Представлены результаты ретроспективного исследования, в которое были включены 105 недоношенных с ОНМТ и ЭНМТ, рожденные с января 2004 по декабрь 2016 года. Анализировали частоту и объем гемотрансфузий, возраст новорожденных при проведении первой гемотрансфузии, осложнения и исходы противоанемических профилактических и лечебных мероприятий, проведенных у детей с ОНМТ и ЭНМТ. Выявлено статистически значимое снижение частоты гемотрансфузий у детей при применении комплекса профилактических мер, включающих сочетание отсроченного пережатия пуповины (сцеживание/«милкинг») и последующей терапии эритропоэтином, стимулятором эритропоэза. В группе детей, получавших терапию эритропоэтином, но не прошедших процедуру сцеживания пуповины, не выявлено статистически значимого снижения частоты гемотрансфузий. Показано, что трансфузия эритроцитсодержащих компонентов крови повышает риск развития бронхолегочной дисплазии, ретинопатии и перивентрикулярной лейкомаляции. Поздняя терапия эритропоэтином (с 8-х суток жизни) не повышает риск развития тяжелых форм ретинопатии недоношенных.
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Pediatric Hematology/Oncology and Immunopathology. 2017; 16: 13-20

Prevention and treatment of anemia of prematurity in extremely and very low birth weight infants

Sharafutdinova D. R., Balashova E. N., Pavlovich S. V., Kirtbaya A. R., Ionov O. V., Lenyushkina A. A., Zubkov V. V., Degtyarev D. N.

https://doi.org/10.24287/1726-1708-2017-16-4-13-20

Abstract

Evaluation and treatment of anemia of prematurity in extremely and very low birth weight infants are presented in this article. Research has been set as a retrospective analysis of 105 infants with anemia of prematurity (in the period from January 2004 to December 2016). This study aimed to analyze the frequency, the volume of red blood cells (RBC) transfusions, the age of the first RBC transfusion and factors associated with RBC transfusions in extremely and very low birth weight preterm infants. A combination of delayed umbilical cord clamping ("milking") and therapy with erythropoietin decrease significantly the frequency of RBC transfusion. There was no significant reduction in the frequency of RBC transfusions in the group of children treated only with erythropoietin, without milking. RBC transfusions increase the risk of bronchopulmonary dysplasia, retinopathy and periventricular leukomalacia. Late therapy with erythropoietin (from 8 days of life) does not increase the risk of developing severe forms of retinopathy of prematurity.

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38. Chapman J., Marfurt S., Reid J. Effectiveness of Delayed Cord Clamping in Reducing Postdelivery Complications in Preterm Infants: A Systematic Review. J Perinat Neonatal Nurs 2016; 30 (4): 372-8.