摘要
目的分析影响新生儿换血治疗后贫血的相关因素,探讨干预策略。方法回顾新生儿高胆红素血症换血治疗病例82例,比较换血后贫血组与非贫血组入院时、换血前、换血后红细胞和血红蛋白变化特点,分析影响因素。结果82例换血后血清胆红素明显下降(P<0.001),红细胞、血红蛋白上升(P<0.001)。但仍有39例(47.56%)存在贫血。两组在换血前红细胞、血红蛋白均较入院时下降,非贫血组下降较贫血组明显,经采取补输血,最终贫血均被纠正(P<0.001)。换血后贫血与换血前贫血、高胆红素血症的病因、输血达预定量后补输血等有关。结论换血治疗能有效降低血清胆红素;达到换血标准的高胆红素血症患儿入院时常存在血红蛋白“正常”假象;换血前贫血者易导致换血后贫血。ABO溶血病、G6PD缺乏并ABO溶血病患儿换血后贫血发生率较其他病因高。输血达预定量后补输血10～15ml/kg有利于纠正换血后贫血。
Objectives To analyze the correlation factors and intervention strategies for anemia after exchange transfusion in neonates. Methods The study included 82 newborns with hyperbilirubinemia treated by blood exchange transfsion. Based on the levels of red blood cells （RBCs） and hemoglobin,correlation factors were investigated between anemic and non-anemic groups on the day of hospitalization ,before and after blood exchange transfusion. Results Although anemia was still observed in 39 cases （47.56 % ） after exchange transfusion,the level of serum bilirubin significantly decreased （P〈0.001 ） while the levels of RBCs and hemoglobin increased （P〈0.001 ） in all 82 subjects. The levels of RBCs and hemoglobin were lower in both groups before exchange transfusion than on the day of hospitalization,especially in non-anemic group. Anemia was relieved after additional blood transfusion （P〈0.001 ）. Anemia after exchange transfusion was related to existence of anemia before exchange transfusion, causes of hyperbilirubinemia, and administration of additional blood transfusion. Conclusions Exchange transfusion can effectively decrease the level of serum bilirubin. Neonates with hyperbilirubinemia,who met the criteria of exchange transfusion,usually had a false impression with normal hemoglobin level on the day of hospitalization. The neonates with anemia before exchange transfusion were liable to have anemia after transfusion. The occurrence of anemia after exchange transfusion was higher in neonates with ABO hemolytic disease and G6PD deficiency than in neonates with other diseases. Additional transfusion at 10-15 ml/kg above the expected level was favorable for correction of anemia after exchange transfusion.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2006年第10期827-830,共4页
Journal of Clinical Pediatrics
关键词
换血治疗
贫血
新生儿
exchange transfusion
anemia
neonate
