新生儿高胆红素血症换血治疗效果评价  

The Evaluation of Exchange Transfusion Efficacy in Neonatal Hyperbilirubinemia

作　　者：林静霞[1] 苏凡[1] 李易娟[1] 周振海[1] 

机构地区：[1]中山大学附属第一医院,广东广州510080

出　　处：《现代医院》2016年第6期809-811,共3页Modern Hospitals

摘　　要：目的比较新生儿换血治疗前后血液指标,评价换血疗效。方法回顾性分析近13年来34例新生儿换血术,研究应用的疾病类型以及换血疗效。结果 34例换血患儿中,Rh溶血病17例,ABO溶血病4例,葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症5例,其它8例。母婴血型不合占61.8%。年均换血2.6例,每例平均换血量为(447.4±164.6)m L。总体上,总胆红素、直接胆红素、间接胆红素、白细胞计数、血红蛋白值、血小板计数、钠、钙、血糖水平换血前后的差异均有统计学意义(均P<0.05)。换血前后患儿机体内环境保持较衡定,胆红素水平明显下降,贫血情况明显改善。换血术不良反应主要为低血钙、暂时性高血糖、血小板减少和贫血等。结论母婴血型不合是新生儿换血主要原因。对具有严重高胆红素血症风险的患儿应早期干预,避免出生后应用换血术治疗。Objective Compared the blood indexes before and after exchange transfusion, to evaluate the treatment efficacy. Methods 34 neonates underwent exchange transfusion in the recent 13 years were retrospectively analyzed, and studyed the disease types and treatment efficacy. Results Of the 34 neonates, Rh hemolytic disease 17 cases, ABO hemolytic disease 4 cases, glucose-6- phosphate dehydrogenase （G6PD） deficiency 5 cases, the others 8 cases. The maternal and child blood incompatibility hemolytic disease was accounted for 61.8%. The annual implementation was 2.6 cases. The mean infusion was （447.4 ±164.6） mL. Overall, Before and after the exchange transfusion, the total bilirnbin, direct bilirubin, indirect bilirnbin, white blood cell count, hemoglobin, platelet count, sodium, calcium and blood sugar level changes difference had statistical significance （ P 〈 0.05 ）. All neonates kept the environment uniform, anemia improved, and bilirubin level declined obviously. The adverse reaction was mainly for low blood calcium, temporary hyperglycemia, thromboeytopenia and anemia. Conclusion The maternal and child blood incompatibility hemolytic disease was the main reason for exchange transfusion. For neonates with severe hyperbilirnhinemia risk should be earlier treated, to prevent the application of exchange transfusion.

关 键 词：换血 红细胞输注量 血浆输注量 RH溶血病 

分 类 号：R722.18[医药卫生—儿科]