换血术对新生儿相关检验指标的影响分析  

Analysis of the influence of exchange transfusion on related clinical test indicators of neonates

作　　者：何敏[1] 张勇[1] 刘德松[1] 罗欢欢 彭颖 HE Min;ZHANG Yong;LIU Desong;LUO Huanhuan;PENG Ying(Department of Neonatology , Sichuan Provincial Hospital of Women and Children, Chengdu 610045, China)

机构地区：[1]四川省妇幼保健院新生儿科

出　　处：《中国输血杂志》2019年第6期567-570,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨换血术对新生儿相关检验指标的影响。方法回顾性分析本院新生儿科2016年1月1日-2018年11月30日实施单次换血术的106例新生儿,通过病历系统回查相关资料,记录新生儿性别、出生方式、胎龄、入院年龄、体重、病因、换血术红细胞血浆比、补钙情况、动脉置管部位,换血术前、换血至总量一半时、换血术结束的血常规、肝功、电解质、血糖值等。结果换血前后血清钠、总二氧化碳、乳酸、血红蛋白变化不具有统计学意义(P>0.05);总胆红素、白细胞、血小板、血清钙、血清钾、白蛋白均有统计学意义(P<0.05);红细胞及血糖显著升高(P<0.05);换血后血小板减少及高血糖的发生率显著增加(P<0.05)。结论换血术能快速有效地降低新生儿血清胆红素水平;换血术并不增加低钙血症发生率,不建议常规补钙;应密切观察各项检验指标的变化及临床表现,及时发现不良反应,以保证患者安全。Objective To explore the effects of exchange transfusion on related clinical test indicators of neonates.Methods A retrospective analysis was made on 106 newborns who received single exchange transfusion from January 1, 2016 to November 30, 2018 in the Department of Neonatology of our hospital. Retrospective review of such data as sex, mode of birth, gestational age, age of admission, body weight, etiology, erythrocyte plasma ratio, calcium supplementation and arterial catheterization were recorded through medical record system of our hospital. Otherwise, the results of blood routine, liver function, electrolyte and blood glucose value before, during and at the end of exchange transfusion were recorded, respectively. Results There were no significant changes in serum sodium, total carbon dioxide, lactic acid and hemoglobin after exchange transfusion(P>0.05).The changes of total bilirubin, white blood cells, platelets, serum calcium, serum potassium and albumin after exchange transfusion were significant.(P<0.05).After exchange transfusion,erythrocyte and blood glucose value increased significantly(P<0.05), along increased significantly the incidence of thrombocytopenia and hyperglycemia(P<0.05). Conclusion Exchange transfusion can rapidly and effectively reduce the serum bilirubin level of neonates without any increase of the incidence of hypocalcemia, so routine calcium supplementation is not recommended.The changes of clinical test indicators and manifestations should be closely observed and adverse reactions should be handle in early stage to ensure the safety of neonates.

关 键 词：换血术 新生儿 胆红素 

分 类 号：R457.1[医药卫生—治疗学] R722[医药卫生—临床医学]