换血治疗新生儿重度高胆红素血症142例临床分析  

Clinical analysis on blood exchange transfusion in treating 142 cases of neonatal severe hyperbilirubinemia

作　　者：彭小友 周杰英[2] 李胜涛[2] 史文元[2] 欧阳向东[3] 曹友德[1] 

机构地区：[1]湖南师范大学第一附属医院检验科,湖南长沙410005 [2]郴州市第一人民医院检验医学中心,湖南郴州423000 [3]郴州市第一人民医院新生儿科,湖南郴州423000

出　　处：《国际检验医学杂志》2017年第21期2977-2978,2981,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨新生儿重度高胆红素血症的病因构成和换血术的临床疗效及安全性。方法对142例重度高胆红素血症新生儿进行换血治疗,分析换血前后血清总胆红素、间接胆红素、直接胆红素水平和血常规指标变化。结果引起新生儿重度高胆红素血症的主要病因为:细菌性感染(28.20%)、葡萄糖-6-磷酸脱氢酶缺乏(27.50%)、新生儿母婴ABO血型不合(16.20%)。重度高胆红素血症新生儿术后血清总胆红素、间接胆红素、直接胆红素水平和血常规指标明显低于术前,差异有统计学意义(P<0.05)。总胆红素换出率为(54.40±9.90)%,术中不良反应率为3.50%,术后血小板减少症发生率为72.00%。结论换血治疗新生儿重度高胆红素血症具有临床意义,但要加强血液学和生化指标等监测,避免不良反应的发生。Objective To explore the cause constituents of neonatal severe hyperbilirubinemia and the clinical efficacy and safety of blood exchange transfusion treatment.Methods 142 neonates with severe hyperbilirubinemia conducted the blood exchange transfusion therapy.The levels of serum total bilirubin,indirect bilirubin and direct bilirubin and the change of blood routine indicators were analyzed before and after blood exchange transfusion.Results The main causes leading to neonatal severe hyperbilirubinemia were bacterial infection（28.20%）,glucose-6-phosphate dehydrogenase（G6 PD）deficiency（27.50%）and pregnant women with ABO blood group incompatibility（16.20%）.The levels of serum total bilirubin,indirect bilirubin,direct bilirubin and blood routine indicators after operation in neonates with severe hyperbilirubinemia were significantly lower than those before operation,the differences were statistically significant（P0.05）.The total bilirubin swap exchange was（54.40±9.90）%.The intraoperative adverse reactions rate was 3.50%.The postoperative thrombocytopenia occurrence rate was 72.00%.Conclusion The blood exchange transfusion for treating neonatal severe hyperbilirubinemia possesses has clinical significance,but the hematology and biochemical indicators monitoring should be strengthened for avoiding adverse reactions occurrence.

关 键 词：高胆红素血症 病因构成 新生儿换血治疗 疗效与安全性 

分 类 号：R722.1[医药卫生—儿科]