机械通气下换血疗法在极危重新生儿高胆红素血症治疗中的临床价值分析  

Clinical value of exchange transfusion treatment under mechanical ventilation for severe neonatal hyperbilirubinemia

作　　者：李春蕾[1] 

机构地区：[1]海南省人民医院新生儿科,海南海口570311

出　　处：《中国现代医学杂志》2015年第13期83-86,共4页China Journal of Modern Medicine

摘　　要：目的探讨机械通气下换血疗法治疗极危重新生儿高胆红素血症的临床价值。方法该院诊治的22例机械通气的极危重新生儿高胆红素血症患者,待生命体征趋于平稳后,给予外周动静脉血换血治疗,观察和比较换血前后胆红素、白蛋白、B/A变化,血常规及凝血功能指标变化,生命体征指标变化情况,以及治疗期间并发症发生情况。结果与换血前相比,换血后总胆红素、直接胆红素、间接胆红素、白蛋白、B/A比值和血小板(PLT)均明显降低(P<0.05);与换血前相比,换血后红细胞(RBC)、K+、Ca2+、Na+、Cl-、凝血酶原时间(PT)和部分凝血活酶时间(APTT)没有明显变化(P>0.05);与换血前相比,换血后体温、呼吸、心率和血压比较差异无统计学意义(P>0.05)。治疗期间没有出现颅内出血、坏死性小肠结肠炎等严重并发症。结论机械通气下换血疗法治疗极危重新生儿高胆红素血症,具有疗效显著、并发症少等优点,明显改善患儿的预后质量。【Objective】To study the clinical value of exchange transfusion treatment under mechanical ventilation for severe neonatal hyperbilirubinemia. 【Method】Twenty-two cases of severe neonatal hyperbilirubinemia in newborns who underwent mechanical ventilation in our hospital were received the peripheral arteriovenous blood exchange transfusion treatment after vital signs were stable. The changes of bilirumbin, albumin, B/A, the changes of blood routine and coagulation, the changes of viatal signs before and after treatment, and the complications during the treatment period were observed and compared. 【Results】 Compared with the pre-exchange transfusion, the TBIL, DBIL, indirect bilirubin, albumin, B/A ratio, and PLT were significantly decreased after exchange transfusion（P〈0.05）. Compared with the pre-exchange transfusion, the levels of RBC, K^＋, Ca^2＋, Na^＋, Cl^-, PT, APTT were not significantly changed after exchange transfusion（P 〉0.05）. Compared with the pre-exchange transfusion, the differences in temperature, respiration, heart rate and blood pressure after exchange transfusion were not statistically significant（P 〉0.05）. There were no serious complications such as intracranial hemorrhage and necrotizing enterocolitis during the treatment period.【Conclusions】The exchange transfusion treatment under mechanical ventilation for severe neonatal hyperbilirubinemia has advantages of remarkable curative effect and fewer complications, and significantly improves the prognosis.

关 键 词：机械通气 换血疗法 新生儿 高胆红素血症 

分 类 号：R722.17[医药卫生—儿科]