新生儿红细胞增多症部分换血方法比较

COMPARE WITH METHOD OF PARTIAL EXCHANGE TRANSFUEIONS OF NEONATAL POLYCYTHEMIA

对29例新生儿红细胞增多症作部分换血。通过症状学、血液学、血生化学对不同稀释液、抽血部位、换血量进行比较后表明:(1)脐静脉换血应谨慎;后囟部抽血不易固定且易感染;从桡动脉按5 ml/kg/min慢速抽血更为合适。(2)症状重、有合并症或红细胞压积过高者,宜按公式计算出量后一次性换血,但换血量超过28ml/kg时可致贫血。(3)生理盐水作稀释液对改善体征及血液学变化,作用优于血浆及白蛋白。

Partial exchange transfusins were performed in 29 neonates with poly- cythemia. Compared with the different dilutions, the locations of taking blood and the volume exchanged according to symptomatology, hematology and qiochemistry.we teel that:(1) As for locations of taking blood, cau- tion should be given in umbilical vein; it is difficult to fix needle in posterior fontanel and easy to get infected; however, it is suitalle to take blood from radial artery at the speed of 5ml/kg/min.(2) It is advi- sable to transfuse total volume calculated based on the fosmula in patients with severe symptoms, complications or high hemotocxit, but anemia will develop if the volume>28ml/kg. (3) Normal saline to be used as dilu- tion acts better than plasma or allumin in improving symptomatology and hemotological changes.