不同比例重组血对新生儿溶血病换血治疗后血液内环境的影响  

Effect of Different Proportions of Mixed Blood Exchange Transfusion on Blood Internal Environment in Neonates with Hemolytic Disease

作　　者：可秋萍[1] 王庆九[1] 庞桂芝 马云 张卫星[1] 张虹[1] 张天美[1] 

机构地区：[1]新乡市中心医院儿科,河南新乡453003 [2]新乡市中心血站,河南新乡453003

出　　处：《实用儿科临床杂志》2008年第14期1078-1079,共2页Journal of Applied Clinical Pediatrics

基　　金：新乡市科技发展计划项目资助(07SO12)

摘　　要：目的探讨不同比例重组血对新生儿溶血病换血后血液内环境的影响。方法对31例新生儿溶血病患儿采用不同比例重组血行外周动静脉同步换血术,均采用O型洗涤红细胞和AB型血浆,其中治疗组（16例）二者比例为1：1（即O型洗涤红细胞2U：AB型血浆200mL）按80±mL/kg单倍量换血,对照组（15例）为2：1（即O型洗涤红细胞4U：AB型血浆200mL）按150~180mL/kg双倍量换血,监测换血前后新生儿血清总胆红素换出率、血RBC、血红蛋白（Hb）、红细胞比容（HCT）、换血量、住院天数等指标的变化。结果治疗组与对照组患儿血清胆红素换出率分别为（44.92±3.99）%和（45.69±5.06）%,二组比较无显著性差异（P=0.639）;住院天数[（8.13±1.13）dvs（8.19±0.91）d]亦无显著性差异（P=0.884）。治疗组换血后RBC、Hb及HCT的水平均提高（P〈0.05,0.01,0.001）,但提高的水平略低于对照组,贫血已基本纠正,临床症状改善,在换血量方面比较治疗组显著低于对照组（P=0）。结论采用1：1单倍量重组血治疗新生儿溶血病,既能降低血中胆红素水平,又可减少换血量。Objective To explore the effect of different proportions of mixed blood exchange transfusion on blood circulation in neonates with hemolytic disease. Methods Thirty - one newborn infants with hemolytic disease were treated by peripheral arteriovenous synchroniza- tion of exchange transfusion with different proportions mixed blood. AB type plasma was mixed with O type red blood cell（RBC） washing. The proportion for the treatment group was 1 ： 1 （ the O type RBCs 2 U ： the AB type plasma 200 mL） ,by exchange transfusion of haplotypes,in accordance with 80 ± mL/kg;the proportion for control group was 2 ： 1 （ the O type RBC 4 U ： the AB type plasma 200 mL） ,by exchange transfusion of double in accordance with 150- 180 mL/kg. The indicators were detected,such as the exchange rate of neonatal serum biliru- bin, RBC, hemoglobin （ Hb）, hematocrit （ HCT）, and the exchange transfusion quantity and days of hospitalization before and after the ex- change transfusion were analyzed. Results The exchange rate of serum bilirubin of treatment group and control group was （44.92 ± 3.99） % and （45.69 ± 5.06） % , respectively, there was no significant difference between 2 groups（P = 0. 639）, there was no significant difference of hospitalization days[ （8.13 ± 1.13） d vs（8.19 ±0.91 ） d] between 2 groups（P =0. 884）. After exchange transfusion in treatment group,the average level of the RBC, Hb and HCT were increased（ P 〈 0.05,0.01,0. 001 ）, although the level of increase was slightly lower than those of control group ,but had been basically correct anemia, clinical symptoms improve. The amount of exchange transfusion quantit in treatment group was lower than that of control group（ P = 0）. Conclusions The exchange transfusion with 1 ： 1 haplotypes mixed blood on neonatal he- molytic disease can decrease the level of bilirubin in blood and reduce the amount of exchange transfusion as well. J Appi Clin Pediatr, 2008,23 （14） ： 1078 - 1079

关 键 词：婴儿 新生 溶血病 单倍量换血 不同比例 重组血 

分 类 号：R722.1[医药卫生—儿科]