高球浆比全血置换联合茵栀黄口服液治疗重度Rh血型不合新生儿溶血病15例  

Exchange Transfusion Using High Ratio of Erythrocyte to Plasma Combined with Yinzhihuang Oral Liquid in Treatment of 15 Cases of Severe Rh Blood Group Incompatibility of Hemolytic Disease of Newborn

作　　者：马印图[1] 李莉华[2] 张静[2] 李玉秋[2] 宋俊贞[2] 

机构地区：[1]解放军白求恩国际和平医院输血科,石家庄050082 [2]河北省血液中心检验科,石家庄050071

出　　处：《解放军医药杂志》2014年第1期55-57,共3页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省计生委科技攻关计划课题(2011-A24)

摘　　要：目的回顾性评价高球浆比全血置换联合茵栀黄口服液治疗重度Rh血型不合新生儿溶血病(hemolyticdisease of newborn,HDN)的疗效。方法选择2011年4月—2012年12月确诊的Rh血型不合HDN 15例,给予高球浆比全血置换联合茵栀黄口服液治疗,监测治疗前后胆红素、总胆红素/白蛋白(B/A)、血常规、血生化指标的变化,评价安全性及转归情况。结果本组治疗后血清总胆红素(TBIL)、间接胆红素(IBIL)、直接胆红素(DBIL)、总胆红素/白蛋白(B/A)以及白细胞和血小板计数、Ca2+均较治疗前下降,差异均有统计学意义(P<0.05,P<0.01)。3例出现轻度腹泻,给予药物减量后好转;5例出现代谢性酸中毒,随即给予纠正。临床痊愈出院14例,1例放弃继续治疗。结论高球浆比全血置换联合茵栀黄口服液治疗Rh血型不合HDN具有很好效果,且安全性较高。Objective To retrospectively evaluate exchange transfusion using high ratio of erythrocyte to plasma combined with Yinzhihuang oral Liquid in treatment of severe Rh blood group incompatibility of hemolytic disease of newborn （HDN）. Methods Fifteen cases of severe Rh blood group incompatibility of HDN during April 2011 and December 2012 underwent exchange transfusion using high ratio of erythrocyte to plasma combined with Yinzhihuang oral Liquid. Changes of serum bilirubin level, the ratio of total bilirubin/albumin （B/ A） , routine blood test and blood biochemical indicators before and after treatment were monitored, and the safety and turnover were observed. Results The serum total bilirubin （TBIL） , indirect bilirubin （IBIL） , direct bilirubin （DBIL） , B/ A, counts of white cells and blood platelets and Ca2 ＋ level after treatment were all lower than those before treatment, and the differences were statistically significant （P 〈 0.05, P 〈 0.01）. Three patients had mild diarrhea and were relieved after drug decrement; five patients had metabolic acidosis and were treated immediately. A total of 14 patients were cured, but 1 patient gave up further treatment. Conclusion The exchange transfusion using high ratio of erythrocyte to plasma combined with Yinzhihuang oral Liquid is effective and safe in treatment of severe Rh blood group incompatibility of HDN.

关 键 词：黄疸 新生儿 RH血型系统 交换输血  茵栀黄口服液 

分 类 号：R722.18[医药卫生—儿科]