双管同步换血治疗新生儿高胆红素血症的临床观察  

Exchange transfusion through peripheral blood vessels for treating neonatal hyperbilirubinemia

作　　者：华子瑜[1] 徐天鹤[1] 余加林[1] 漆正常[1] 李世红[1] 陈贻骥[1] 包蕾[1] 王家蓉[1] 

机构地区：[1]重庆医科大学附属儿童医院新生儿科,重庆400014

出　　处：《儿科药学杂志》2003年第5期29-31,共3页Journal of Pediatric Pharmacy

摘　　要：目的:研究经外周血管双管同步换血治疗新生儿高胆红素血症的疗效和危险性,分析其预后。方法:分析我院新生儿科经外周血管双管同步换血的高胆红素血症患儿的血清学、G鄄6PD活性、脑干听觉诱发电位(BAEP)和头颅CT,比较换血前后的血清总胆红素(TB)、血糖、电解质等生化检查结果。结果:ABO溶血病60.0%,Rh溶血病13.0%,G鄄6PD缺陷症16%,其他11%;换血后TB下降53.7%±0.103%;换血可引起血糖升高,血钾、血钙、血镁降低;患儿的BAEP异常率51.6%,头颅CT检查异常率84.6%。结论:新生儿严重的高胆红素血症易引起BAEP及头颅CT异常,经外周血管双管同步换血可迅速降低血清胆红素水平,减少胆红素脑病的发生;但可能引起高血糖症、电解质紊乱,增加循环负荷,并发感染等,应慎重选择其适应征。Objective:To explore efficacy of exchange transfusion through peripheral blood vessels for treating neonatal hyperbilirubine-mia,to analyze the prognosis of severe hyperbilirubinemia.Methods:One hundred cases receiving exchange transfusion(ET)therapy in our ward from October of2000to May of2002were collected,the results of seroimmune test,BAEP,CT and G-6PD activity were ana-lyzed,serum total bilirubin,blood glucose,serum electrolytes,renal function,arterial blood gas analysis pre and post transfusion com-pared.Results:Of these cases,those of ABO hemolytic disease account for60.0%,Rh hemolytic disease for13.0%,G-6PD deficiency for16.0%.ET decreased serum bilirubin sharply and the decreasing rate was about53.7%±0.103,transfusion caused hyperglucosemia,hypocalcemia and hypomegnemia.Incidence of abnormal BAEP was about51.6%,while that of abnormal CT of brain was about84.6%.Conclusions:Hyperbilirubinemia was very dangerous for neonates because of its neural toxicity,so we should be careful about it.Ex-change transfusion through peripheral blood vessels could decrease serum bilirubibin level in short time to reduce kernicterus.Exchange transfusion was not safe because that it might result in infection,imbalance of inner environment.Therefore,we should use transfusion therapy very carefully.

关 键 词：双管同步换血 治疗 新生儿 高胆红素血症 预后 病理性黄疸 

分 类 号：R722.17[医药卫生—儿科] R457[医药卫生—临床医学]