摘要
目的：探讨新生儿重症高胆红素血症采用经外周动静脉快速同步换血治疗的可行性。方法：对46例符合采用换血疗法的新生儿高胆红素血症患儿进行换血疗法,治疗中予以持续心电监护和监测体温、心率、血压、呼吸、经皮血氧饱和度,并保证各管道的通畅。结果：平均换入血量（168.12±21.64）ml/kg,平均抽出血量（162.20±18.39）ml/kg;换血时间100～240 min,平均180 min。换血后总胆红素、直接胆红素、间接胆红素换出率分别为48.61%、47.06%和53.85%,三者换血前后比较差异有统计学意义（P〈0.05）;换血后白细胞、血红蛋白、血小板计数明显下降,血K＋、Ca2＋浓度有所下降,血糖水平升高（P〈0.05）;红细胞数和血Na＋、C1-浓度无明显变化。无明显换血并发症发生。结论：外周动静脉快速同步换血可大大降低患儿的死亡率及致残率。
Objective： To explore the feasibility of application of peripheral arteriovenous fast synchronous exchange transfusion in the treatment of neonates with severe hyperbilirubinemia. Methods： Forty-six cases of neonates with hyperbilirubinemia, who meet the requirement of exsanguinotransfusion therapy, were treated by exchange transfusion. During treatment, the monitoring of continuous ECG, body temperature, heart rate, blood pressure, respiratory and percutaneous oxygen saturation was carried out and the smoothness of all pipelines was surely maintained. Results： The average amount of blood transfusion was（168.12±21.64） ml/kg, the mean volume of blood drawing was（162.20 ± 18.39） ml/kg and the time for exchange transfusion was 100～240 min with the average 180 min. After exchange transfusion, the exchange rates of total bilirubin, direct bilirubin, indirect bilirubin were 48.61%, 47.06% and 53.85%, respectively. Their differences had statistical significance before and after exchange transfusion（P〈0.05）. The count of leukocyte, hemoglobin and platelet was obviously decreased, the concentrations of serum K＋, Ca2＋ ion were slightly decreased while blood glucose level was elevated（P 0.05） after exchange transfusion. There was no obvious change in red blood cell count and the concentrations of blood Na＋ and C1- ion and no significant complications related to exchange transfusion occurred. Conclusion： The morbidity and mortality in ill neonates can be greatly reduced by peripheral arteriovenous synchronous fast exchange transfusion.
出处
《上海医药》
CAS
2014年第13期40-42,共3页
Shanghai Medical & Pharmaceutical Journal
基金
江西省九江市科技局立项课题一九科字(2012)38号
关键词
新生儿
重症高胆红素血症
换血治疗
neonate
severe hyperbilirubinemia
exchange transfusion
