摘要
目的:探讨外周血管同步换血疗法在新生儿高胆红素血症中临床应用的可行性及疗效。方法:对22例患儿,采用股动脉穿刺放血、头皮颞浅静脉穿刺输血的同步换血方法置换出体内1.5~2.0倍血量。监护生命体征,换血前后查血常规、网织红细胞(RC)、肝功能、血生化等。结果:换血术后血清总胆红素水平平均下降了(47.29±13.43)%,以间接胆红素下降为主;血红蛋白(Hb)、红细胞(RBC)、Na^+、Ca^2+明显下降(P〈0.01),白细胞(WBC)也明显下降(P〈0.05),血糖(Clu)明显升高(P〈0.01)。平均换入血量135ml·kg^-1。20例患儿术后一般情况明显好转,迅速改善机体内环境,仅2例有一过性高血糖,静脉滴注胰岛素1h后好转。结论:外周血同步换血疗法疗效好,简便可行,副作用少,值得推广。
Objective To investigate the feasibility and effectiveness of synchronizing replacement of peripheral blood in treating neonates with hyperbilirubinemia. Methods A catheter was inserted into a scalp temporal vein for infusion of donor blood, meanwhile another catheter connecting three way stopcock was inserted into a femoral artery withdrawing about 1.5 - 2.0 times of internal blood volume. Vital signs were monitored electronically and recorded. Blood routine, reticulocytes, liver function, blood biochemistry and so on were measured before and after transfusion. Results The mean drop in serum bilirnbin concentration was (47.29±13.43 )% after exchange transfusion,mainly in hemobilirubin. Hb,RC, Na^+, Ca^2+ descended significantly (P 〈 0.01 ),and WBC also descended significantly (P 〈 0.05),,and Glu heightened obviously( P 〈 0.01 ) after replacement transfusion. Average blood volume ,exchanged was 135 ml·kg^-1. 20 cases improve the general state of health and internal environment rapidly after treatment, only 2 persons had hyperglycosemia shortly, and became usual after an hour by intravenous dropping insulin. Conclusion The synchronizing replacement transfusion of peripheral blood is practicable and safe with few complications, which is recommended to be widely used.
出处
《东南大学学报(医学版)》
CAS
2007年第1期62-65,共4页
Journal of Southeast University(Medical Science Edition)
关键词
高胆红素血症
外周血置换
新生儿
hyperbilirubinemia
peripheral blood replacement
neonate