全自动换血术对高胆红素血症新生儿血液内环境影响研究  

Study on the internal environment of neonates with hyperbilirubinemia before and after blood exchange transfusion

作　　者：赵海燕[1] 陈红武[1] 沈薇[1] 

机构地区：[1]南方医科大学南方医院新生儿科,广州510515

出　　处：《中国实用儿科杂志》2011年第4期278-280,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨全自动换血术对高胆红素血症新生儿血液学指标的影响,评估其疗效与安全性以及间接胆红素和白蛋白比值的临床意义。方法 2008年1月至2010年5月南方医科大学南方医院对74例重症高胆红素血症患儿均采用周围动静脉同步换血术,监测换血前后胆红素、白蛋白、间接胆红素与白蛋白比值、电解质、血常规。结果血中胆红素、白蛋白、间接胆红素与白蛋白比值、电解质(Na+、K+、Cl-、Mg2+)、血常规换血后均较换血前明显下降,但Ca2+、P3+浓度换血后较换血前升高,差异均有统计学意义。换血术后无患儿发生不良反应。结论换血对胆红素、白蛋白、间接胆红素与白蛋白比值、Na+、K+、Cl-、Mg2+、Ca2+、P3+、白细胞、红细胞、血红蛋白、红细胞压积、血小板均有影响,应注意监测。特别要注意监测间接胆红素与白蛋白比值,该比值是评估胆红素毒性的危险指标。比值越高,其危险性越高,越需要输注白蛋白。Objective To discuss the influence of blood exchange transfusions on blood environment of neonates with hyperbilirubinemian.Methods Blood exchange transfusion was performed in 74 neonates in Nanfang Hospital,Southern Medical University from Jan.2008 to May 2010.Blood bilirubin,albumin,the ratio of indirect bilirubin and albumin,blood electrolyte and blood routine were measured before and after the transfusion.Results Blood bilirubin,albumin,the ratio of indirect bilirubin and albumin and blood electrolyte（Na＋、K-、Cl-、Mg2＋） decreased obviously,but Ca2＋ and P3＋ increased significantly.Conclusion Blood exchange transfusion can influence blood bilirubin,albumin,the ratio of indirect bilirubin and albumin,blood electrolyte and blood routine.All of them should be monitoried before and after blood exchange transfusion,especially the ratio of indirect bilirubin and albumin.It can assess the risk of bilirubin toxicity index.The higher the ratio,the higher the risk,the more need for infusion of albumin.

关 键 词：高胆红素血症 新生儿 换血术 

分 类 号：R72[医药卫生—儿科]