新生儿Rh溶血症17例临床分析

CLINICAL ANALYSIS OF RHESUS HEMOLYTIC DISEASE IN 7 NEONATES

本文分析我院1980年～1990年经实验室试验确诊的新生儿Rh溶血症17例。男13例女4例,黄疸出现时间全部在生后24小时以内。Rh D血型不合9例,Rh E血型不合7例,Rh C血型不合1例,直接抗人球蛋白试验17例均阳性,5例由于严要高胆红素血症故采取换血疗法。1例因入院太晚,未及时换血即死亡。对换血后5例患儿进行随访,经丹佛智能筛选检查法(DDST),仅1例异常,其智力及体格发育落后1年。Rh E溶血症在中国颇为常见,上海报告本症占Rh溶血症34.4％(42/122),本文报告更高达41.2％(7/17)。

Seventeen cases of neonatal homolytic disease due to Rh incompatiblity from 1980-1990 were analysed in this paper. All cases were proved by laboratory tests. Thirteen cases were male and 4 cases female. The appe- rance of jaundice in ill newborn infants occuned within 24 hours after birth. Nine cases were due to D incompatibility; seven cases due to E and 1 case was due to C incompatibility. The direct Coombs test was pasitive in all 17 cases. Exchange transfusions were performed in 5 cases due to severe hyperbilirubinema. 1 case died, because he was admitted too late and exchange transfusion could not be performed. Follow up study of 5 cases, who had received exchange transfusion, revealed that only one case was abnormol by DDST. His mental and physical develo- pment was one year lagged behind. In China Rh E hemolytic disease of the newborn is rather common. It was reported 34.4% (42/122) of hemoly- tic disase due to Rh incompatibility in Shanghai. In this report it was as high as 41.2% (7/17).