新生儿高胆红素血症换血治疗安全性研究  

Study on the safety of exchange transfusion for neonates with hyperbilirubinemia

作　　者：张慧[1] 李贵南[1] 袁远宏[2] 周勇[1] 杨慧[1] 孙正香[1] 

机构地区：[1]湖南省儿童医院新生儿,长沙410007 [2]湖南省儿童医院重症监护1科,长沙410007

出　　处：《中国实用儿科杂志》2011年第4期275-277,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨换血治疗对高胆红素血症新生儿血清白细胞介素(IL-1b)、IL-6,肿瘤坏死因子α(TNF-α)及皮质醇(Cor)含量的影响,旨在判断换血治疗是否将引起患儿应激反应,影响疾病的恢复。方法 2009年8月至2009年12月在湖南省儿童医院新生儿科住院诊断为新生儿高胆红素血症,并进行了外周动静脉双通道同步换血治疗的足月新生儿共56例,均留取换血治疗前所抽出的第一管血以及换血治疗结束后24h、168h的血标本,测定血清IL-1b、IL-6、TNF-α及Cor含量。结果治疗后24h与治疗前比较,血清Cor浓度明显下降,差异有统计学意义(P<0.01);血清IL-1b、IL-6、TNF-α浓度差异无统计学意义(P>0.05)。治疗后24h与治疗后168h比较,各细胞因子血清浓度差异无统计学意义(P>0.05)。治疗后168h与治疗前比较,血清IL-6、TNF-α浓度差异无统计学意义,IL-1b浓度增高,差异有统计学意义(P<0.05);Cor浓度降低,差异有统计学意义(P<0.01)。结论换血治疗技术成熟,严格规范操作的换血治疗对机体不会产生重大的应激,是治疗新生儿高胆红素血症比较安全有效的方法。Objective To study the influence of exchange transfusion on serum interleukin （IL-1b,IL-6）,tumor necrosis factor α （TNF-α） and cortisol （Cor） content in neonatal hyperbilirubinemia,and to identify whether the exchange transfusion will cause stress reaction of the neonates and influence the recovery of disease.Methods In the Department of Neonate in Hunan Children’s Hospital between August 2009 and December 2009,56 full-term neonates who were diagnosed with neonatal hyperbilirubinemia were treated with peripheral arteriovenous dual-channel synchronous exchange transfusion.Take the first tube of blood before exchange transfusion and 24 h and 168 h blood after exchange transfusion;detect serum IL-1b,IL-6,TNF-α and cortisol content.Results The cortisol content was decreased obviously at 24 h after exchange transfusion compared with that before treatment,there being significant differences（P 0.01）.The serum IL-1b,IL-6,TNF-α content before treatment had no obvious difference compared with that at 24 h after treatment（P 0.05）.The concentrations of each cytokine in 24 h were of no obvious differences compared with that at 168 h after treatment（P 0.05）.The concentrations of IL-6 AND TNF-α at 168 h after treatment were of no obvious differences compared with that before treatment（P 0.05）,but the concentrations of IL-1b was increased,there being significant differences（P 0.05）;cortisol content was decreased,there being significant differences（P 0.01）.Conclusion At present,exchange transfusion is a mature technology,it won’t cause serious stress reaction under normative operation,and it is a safe method to cure neonatal hyperbilirubinemia.

关 键 词：高胆红素血症. 换血治疗 新生儿 应激 

分 类 号：R722.17[医药卫生—儿科]