双倍剂量换血疗法联合不同剂量人免疫球蛋白针静脉注射治疗ABO溶血所致新生儿高胆红素血症的效果观察  

Observation of curative effect of double-dose exchange transfusion combined with intravenous injection of different doses of human immunoglobulin on neonatal hyperbilirubinemia induced by ABO hemolysis

作　　者：师淑锋 许邦礼 李晶[1] 董慧茹 Shi Shufeng;Xu Bangli;Li Jing;Dong Huiru(Department of Neonatology,Children’s Hospital Affiliated of Zhengzhou University,Henan Children’s Hospital,Zhengzhou Children’s Hospital,Zhengzhou 450018,China)

机构地区：[1]郑州大学附属儿童医院、河南省儿童医院、郑州儿童医院新生儿内科,郑州450018

出　　处：《中国实用医刊》2023年第13期28-32,共5页Chinese Journal of Practical Medicine

摘　　要：目的探究双倍剂量换血疗法联合不同剂量静脉注射人免疫球蛋白针治疗ABO溶血所致新生儿高胆红素血症的效果。方法抽取2018年6月至2021年12月在郑州大学附属儿童医院新生儿科住院确诊为ABO溶血导致的高胆红素血症的新生儿87例,按随机数字表法分为A、B、C三组,每组29例。A组给予0.5 g/kg免疫球蛋白针联合双倍剂量换血疗法,B组给予1.0 g/kg免疫球蛋白针联合双倍剂量换血疗法,C组仅采用双倍剂量换血疗法。记录三组患儿的临床一般资料。采用胆红素氧化酶法检测血清总胆红素(TSB)水平,计算TSB换出率;采用全自动血液生化分析仪检测换血前后患儿血常规和血生化指标[血红蛋白(Hb)、白细胞计数(WBC)、血小板计数(PLT)、血糖、白蛋白(ALB)、Ca2+、Na+、K+];采用心电监护仪和血压袖带监测患儿平均动脉压(MAP)及心率(HR)。结果治疗后,三组患儿TSB水平均低于治疗前,且B组低于A、C组,组间比较差异有统计学意义(F=209.25,P<0.001)。治疗后,三组患儿Hb、血糖均较治疗前升高,WBC、PLT、Ca2+低于治疗前(P<0.05),但组间比较差异未见统计学意义(P>0.05)。治疗后,三组患儿ALB和Na+水平均低于治疗前,且组间比较差异有统计学意义(P<0.05)。治疗后,三组患儿HR高于治疗前,MAP低于治疗前,且组间比较差异有统计学意义(P<0.05)。结论新生儿高胆红素血症患儿采用静脉注射人免疫球蛋白1.0 g/kg联合双倍剂量换血治疗,治疗效果较好,还可稳定患儿的血液指标。ObjectiveTo investigate the curative effect of double-dose exchange transfusion combined with intravenous injection of different doses of human immunoglobulin on neonatal hyperbilirubinemia induced by ABO hemolysis.MethodsA total of 87 neonates with hyperbilirubinemia induced by ABO hemolysis who were confirmed and hospitalized in Department of Neonatology of Children’s Hospital Affiliated of Zhengzhou University from June 2018 to December 2021 were selected.They were divided into group A,group B and group C by random number table method,with 29 cases in each group.Group A received 0.5 g/kg immunoglobulin injection combined with double-dose exchange transfusion,group B received 1.0 g/kg immunoglobulin injection combined with double-dose exchange transfusion,while group C received double-dose exchange transfusion only.The general clinical data of the three groups were recorded.The level of total serum bilirubin(TSB)was detected by bilirubin oxidase method,and exchange rate of TSB was calculated.The blood routine and blood biochemical indexes,including hemoglobin(Hb),white blood cell count(WBC),platelet count(PLT),blood glucose,albumin(ALB),Ca2+,Na+,K+,were detected by full-automatic blood biochemical analyzer before and after exchange transfusion.The mean arterial pressure(MAP)and heart rate(HR)were monitored by electrocardiogram monitors and blood pressure cuffs.ResultsAfter exchange transfusion,the TSB level in three groups were all lower than those before treatment,and the TSB level in group B was lower than that in group A and group C,with statistically significant differences among the three groups(F=209.25,P<0.001).After exchange transfusion,Hb and blood glucose significantly increased,while WBC,PLT,and Ca2+significantly decreased in the three groups(P<0.05),but there was no significant difference in the above indexes among the three groups(P>0.05).After exchange transfusion,the levels of ALB and Na+in the three groups were lower than those before treatment,and there was a statistically significant differe

关 键 词：高胆红素血症 ABO溶血 换血疗法 血常规 血生化 总胆红素换出率 

分 类 号：R722.1[医药卫生—儿科]