换血疗法治疗不同胎龄儿高胆红素血症对内环境的影响  

To study the effect of exchange transfusion on the internal milieu of infants with hyperbillirubinemia of different gestational age

作　　者：宋燕燕[1] 赵小朋[1] 李坚[1] 叶青青[1] 李小晶[1] 黄志坚[1] 韩玉昆[2] 

机构地区：[1]广州市妇婴医院儿科,广东广州510180 [2]中国医科大学第二临床学院儿科,辽宁沈阳110000

出　　处：《中国儿童保健杂志》2006年第3期256-258,323,共4页Chinese Journal of Child Health Care

摘　　要：[目的]探讨换血疗法对不同胎龄儿内环境的影响。[方法]对1991-2004年广州市妇婴医院儿科进行换血的56例新生儿按照胎龄分组,早产儿与足月儿两组,分析其疗效和副作用有无差异。[结果]两组患儿换血后胆红素水平均显著降低(P<0．001),尤其在换血总量前一半时胆红素下降明显,约占总换出量的70％;早产儿换血过程中更易发生内环境紊乱,早产组血钾、白细胞、血色素、血小板下降明显,其变化与足月组比较差异有显著性(P<0．01或 0．05)。[结论]换血疗法治疗不同胎龄新生儿高胆红素血症,疗效确切。尽管其所致的内环境改变,如血生化异常、血小板减少症等通常可自我调节,但对早产儿而言仍不容忽视。[Objectives] To study the effect of exchange transfusion on the internal milieu of infants with different gestational age. [Methods] 56 infants who underwent exchange transfusion from 1991-2004 were divided into two groups according to their gestational age and the incidence of side effects were analyzed in both groups. [Results] After exchange transfusion, the level of serum hilirubin decreased prominently in both groups （P〈0.001）. Preterm infants were more like ly to develop disturbance of internal milieu （P〈0.01 or 0.05）. [Conclusion] Exchange transfusion is an effective treatment for neonates of different gestational age. Although its side effects including disturbance in blood electrolytes, acidosis or thromhocytopenia may he corrected by self-adjustment, close observation should he given to preterm infants.

关 键 词：换血疗法 早产儿 高胆红素血症 

分 类 号：R722.1[医药卫生—儿科]