换血术对高胆红素血症新生儿血液内环境影响的研究  

Influence of Blood Exchange Transfusion on Hemato-microenvironment of Neonates with Hyperbilirubinemia

作　　者：李坚[1] 赵喆[1] 董海鹏[1] 宋燕燕[1] 赵小朋[1] 

机构地区：[1]广东省广州市妇婴医院新生儿科,510180

出　　处：《中国妇幼保健》2006年第19期2671-2673,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨换血术对高胆红素血症新生儿血液内环境的影响。方法:33例采用外周动静脉同步换血术,19例采用O型红细胞+AB型血浆,14例采用新鲜的(3 d内)与患儿同型ACD全血,平均换血量156.9±30.4 m l/kg。检测换血前中后血常规、血气、电解质、血糖,计量资料用t检验对比分析。结果:换血后可出现贫血,白细胞及血小板均明显下降(P<0.001),而且在换血中已显著下降(P<0.001)。血电解质方面,血钾显著下降,磷也有明显降低。血糖的改变为双向性。血气除PaCO2有一过性显著升高,其余pH、PaO2、H2CO3均无明显差异(P>0.05)。结论:该组换血资料提示:换血对新生儿特别是早产儿容易造成白细胞及血小板明显下降而发生感染或出血。如使用较新鲜血,换血后往往出现血钾下降甚至低血钾症,造成糖代谢紊乱是双向性的,经常规补碱后不易出现代谢性酸中毒。Objective： To discuss the influence of blood exchange transfusions on hemato - microenvironment of neonates with hyperbilirubinemia. Methods： Blood exchange transfusion was performed on 33 neonates, 19 used type O red blood cell ＋ type AB serum, 14 used fresh （ within 3 days ） ACD blood which had same blood type as the patients, mean transfusion volume was 156.9 ＋ 30.4 ml/kg. Blood routine, blood gas analysis, blood sugar was taken before, during and after the transfusion and the data obtained were analyzed using t test. Results： Anemia may occur after blood exchange transfusion Leucocyte and blood platelets decrease in number obviously （ P 〈 0. 001 ）. Decrease obviously during the transfusion （P 〈 0. 001 ）. For blood electrolyte, K ＋ and P decrease obviously. Change of Bs was two ways. For blood gas analysis, there is no significant difference in PH. PaO2 H2CO3 except for reversible rise of PaCO2 （P 〈 0. 05 ）. Conclusion： The data indicates that blood exchange transfusion can easily cause obvious decreasing leucocyte and blood platelets number in neonates. Especially premature infant. If fresh blood is used for transfusion, decrease in blood K ＋ may easily happen. Blood sugar metabolic deficiency is both ways. Metabolicacidos is not easily happen if routine base is given.

关 键 词：新生儿 换血术 血液内环境 

分 类 号：R722.5[医药卫生—儿科]