外周动静脉同步双泵换血疗法对新生儿高胆红素血症患儿血液内环境的影响  

Effect of synchronous double-pump exchange transfusion of peripheral artery and vein on blood environment in neonatal hyperbilirubinemia

作　　者：杨文智 王利维[2] 吕静雯 Yang Wenzhi;Wang Liwei;Lyu Jingwen(Neonatal Intensive Care Unit,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China;Department of Neonatology,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院新生儿重症监护室,上海200092 [2]上海交通大学医学院附属新华医院新生儿科,上海200092

出　　处：《保健医学研究与实践》2023年第9期68-72,共5页Health Medicine Research and Practice

基　　金：国家自然科学基金青年项目(82201900)。

摘　　要：目的 分析外周动静脉同步双泵换血疗法对新生儿高胆红素血症(NHB)患儿血液内环境变化的影响。方法 选取2020年10月—2022年4月上海交通大学医学院附属新华医院收治的106例重度NHB患儿作为研究对象,采用随机数字表法分为双泵换血组和手动换血组,每组53例。双泵换血组采用外周动静脉同步双泵换血疗法,手动换血组采用手动换血疗法,比较2组患儿的临床疗效,血液学指标、血常规、电解质指标变化情况及治疗过程中的不良反应发生情况。结果 双泵换血组患儿治疗总有效率为90.57%(48/53),高于手动换血组的75.47%(40/53),差异有统计学意义(χ^(2)=4.283,P=0.038)。2组患儿治疗后血清总胆红素、间接胆红素、白蛋白水平均低于治疗前且双泵换血组血清总胆红素、间接胆红素水平低于手动换血组,白蛋白水平高于手动换血组,差异均有统计学意义(P<0.05);2组患儿治疗后血糖水平高于治疗前,但双泵换血组低于手动换血组,差异有统计学意义(P<0.05)。2组患儿治疗后红细胞计数均高于治疗前,白细胞及血小板计数均低于治疗前,差异均有统计学意义(P<0.05);双泵换血组患儿治疗后血小板计数高于手动换血组,差异有统计学意义(P<0.05)。2组患儿治疗后血氯、血钙、血钠、血钾水平均低于治疗前,差异均有统计学意义(P<0.05);双泵换血组患儿治疗后血钠、血钾水平均高于手动换血组,差异均有统计学意义(P<0.05)。双泵换血组患儿治疗过程中不良反应发生率为11.33%(6/53),低于手动换血组的28.30%(15/53),差异有统计学意义(χ^(2)=4.810,P=0.028)。结论 外周动静脉同步双泵换血疗法较手动换血疗法效果更显著,可有效降低NHB患儿血清胆红素水平,更好地维持血液内环境稳定,减少不良反应发生风险,值得临床推广应用。Objective This paper aims to analyze the effect of synchronous double-pump exchange transfusion of the peripheral artery and vein on the changes in blood environment in neonates with neonatal hyperbilirubinemia(NHB).Methods A total of 106 children with severe NHB admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from October 2020 to April 2022 were selected as the participants and assigned to the double-pump exchange transfusion group(n=53)and manual exchange transfusion group(n=53)by random number table.The double-pump exchange transfusion group was treated with peripheral arteriovenous synchronous double-pump exchange transfusion,and the manual exchange transfusion group with manual exchange transfusion.The clinical efficacy,hematological parameters,blood routine,electrolyte parameters,and adverse reactions during treatment were compared between the two groups.Results The overall response rate in the double-pump exchange transfusion group was significantly higher than that in the manual exchange transfusion group[90.57%(48/53)vs.75.47%(40/53);χ^(2)=4.283,P=0.038].The total serum bilirubin,indirect bilirubin and albumin levels in the two groups after treatment were significantly lower than those before treatment and the albumin level of double-pump exchange transfusion group was significantly higher than the manual exchange transfusion group(P<0.05);the blood glucose level in the two groups after treatment was significantly higher than that before treatment,but the double-pump exchange transfusion group was significantly lower than the manual exchange transfusion group(P<0.05).After treatment,the red blood cell level in the two groups was significantly increased,and the white blood cell and platelet counts were significantly decreased(P<0.05);the platelet counts were significantly higher than those in the manual exchange transfusion group(P<0.05).The serum chloride,calcium,sodium and potassium levels of the two groups after treatment were significantly decreased(P<0.05);

关 键 词：新生儿高胆红素血症 血液内环境 双泵换血疗法 手动换血疗法 胆红素 电解质 

分 类 号：R722.1[医药卫生—儿科]