外周动静脉同步换血治疗重症新生儿高胆红素血症的研究

Study on the treatment of severe neonate hyperbilirubinemia by peripheral arteriovenous synchronous exchange transfusion

目的探讨外周动静脉同步换血疗法治疗重症新生儿高胆红素血症的可行性和疗效。方法对符合条件的12例采用留置针穿刺,外周静脉输血,桡动脉或肱动脉出血,同步进出速度200 ml／h,配血量为患儿两倍的总血量(150-180 ml／kg)。换血前后监测血清总胆红素、间接胆红素、直接胆红素以及生命体征、血氧饱和度的变化。结果换血后血清总胆红素、间接胆红素、直接胆红素下降率分别为57．58％、29．91％、47．67％,差异有显著意义(P<0．05),呼吸、心率、血压、体温、血氧饱和度均稳定,未出现心衰、呼吸暂停等现象。结论外周动静脉同步换血疗法治疗重症新生儿高胆红素血症,简单、易行、疗效可靠、无明显并发症。

Objective To study the effect and feasibility of the treatment of severe neonate hyperbilirubinemia by peripheral arteriovenous synchronous exchange transfusion. Methods 12 patients were selected and treated by retained needle puncture, peripheral arteriovenous transfusion, radial artery or brachial artery bleeding. Synchronous exchange transfusion speed was 200 ml/h, the prepared blood was double the children＇s total blood volume 150-180 ml/kg, the total serum cholesterol, indirect bilirubin,, living sign and saturation oxygen were measured before and after exchange transfusion. Results The total serum bilirubin, indirect bilirubin, and direct bilirubin were reduced to 57.58%, 29.91% and 47.67% respectively. There is significant difference （P〈0.05）. The rate of respiratory, heart rate, blood pressure, body temperature and saturation oxygen were stable, no heart or respiratory failure were found. Conclusion severe neonate hyperbilirubinemia will can be treated by peripheral arteriovenous synchronous exchange transfusion, it is a simple, easy, effective method and without complication.