新生儿高胆红素血症换血治疗用血情况分析  

The Clinical Use of Blood in Exchange Transfusion for Severe Neonatal Hyperbilirubinemia

作　　者：甘珊 段灵 胡红兵 GAN Shan;DUAN Ling;HU Hong-bing(Department of Blood Transfusion,Wuhan Children's Hospital,Tongji Medical College of Huazhong University of Science&Technology,Wuhan 430016)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院输血科,430016

出　　处：《临床输血与检验》2021年第2期185-188,共4页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：湖北省卫生健康委输血专项重点项目(No.WJ2019H339)资助。

摘　　要：目的通过调查单病种临床用血量,对我院新生儿高胆红素血症接受换血治疗的用血情况进行统计和分析,为临床合理用血提供有价值的依据。方法对我院2016年1月~2019年12月新生儿高胆红素血症接受换血治疗的389例患儿的临床资料进行回顾性分析,分别统计患儿的一般情况,并对换血治疗中用血量进行分析统计。结果389例患儿中男212例,女177例,性别差异无统计学意义(P>0.05);A型155例,B型128例,O型80例,AB型26例,患儿血型比较有统计学差异(P<0.001),高胆红素血症患者中O型血患儿换血最少,A型与B型无统计学差异(P>0.05);换血治疗多选用新鲜O型红细胞悬液和AB型新鲜冰冻血浆,O型红细胞用量共计1060 U,占红细胞总量86.14%,AB型血浆49050 mL,占血浆用量的75.81%,平均每例用血量为红细胞悬液3.13 U,新鲜冰冻血浆165 mL。结论通过对新生儿换血用血的分析,总结出用血经验,为优化用血方案提供依据,有效治疗的同时合理用血,节约用血。Objective By investigating the clinical use of blood for single disease,statistics and analysis of blood usage of neonates with hyperbilirubinemia receiving exchange transfusion therapy in our hospital were conducted to provide valuable evidence for rational blood storage in blood transfusion department,planned blood supply at blood station and rational clinical use of blood in clinic.Methods The clinical data of 389 neonates with hyperbilirubinemia receiving exchange transfusion therapy in our hospital between January 2016 and December 2019 were retrospectively analyzed.Data of patient's general condition were provided and the volumes of blood used for the exchange transfusion therapy were analyzed.Results Among the 389 cases of exchange transfusion,212 cases were males,177 cases were females.There was no statistically significant gender difference(P>0.05).One hundred and fifty five cases were blood type A,128 cases were blood type B,80 cases were blood type O,and 26 cases were blood type AB.There was significant difference between blood types(P<0.001).Among patients with hyperbilirubinemia,blood type O had the least volumes of blood for exchange,and there was no significant difference between blood type A and blood type B(P>0.05).Type O packed red blood cells and type AB fresh plasma were the most choice for exchange transfusion therapy.The amount of blood type O packed red blood cells was 1060U,accounting for 86.14%.The amount of blood type AB plasma was 49050 mL,accounting for 75.81%.The average transfusion used in each case was 3.13 units of packed red blood cells and 165 mL of fresh frozen plasma.Conclusion Through the analysis of exchange transfusion in severe neonatal hyperbilirubinemia,we summarized the experience of blood use for exchange transfusion,which will help blood transfusion department to develop a blood storage plan,provide evidence for optimizing transfusion practice.While effective treatment,Rational use of blood and saving blood have been emphasized.

关 键 词：新生儿高胆红素血症 新生儿换血 合理用血 

分 类 号：R457.1[医药卫生—治疗学]