外周动静脉换血治疗新生儿溶血18例疗效观察

Effects of peripheral exchange transfusion on 18 patients with hemolytic disease of the newborn.

【目的】探讨外周动、静脉同步换血疗法对新生儿溶血病的疗效及作用。【方法】采用以桡动脉或肱动脉、大隐静脉或足背静脉作为换出、输入途径,输注与换出平衡的外周动、静脉双管同步换血法治疗18例新生儿溶血病。换血前后监测患儿血清胆红素水平和常用血液生化指标。【结果】换血治疗前后血清胆红素水平的差异有显著性(P<0.01),换血治疗24 h后,血清胆红素水平显著下降。【结论】外周动、静脉双管同步换血疗法可迅速降低血清胆红素水平,改善机体内环境。该法具有疗效快、副作用少、操作简便的特点,值得临床推广应用。

[Objective] To explore the effect of simultaneous exchange transfusion on newborn with hemolytic disease. [Methods] Eighteen patients with hemolytic disease were treated with exchange transfusion, of which a radial artery or a brachial artery was adopted as an import channel and a great saphenous vein or a dorsal foot vein as an output channel. Before and after exchange transfusion, the level of serum bilirubin and blood biochemical indicator were detected. [Results] There was significant difference in serum bilirubin before and after exchange transfusion（P〈0.01）, and the level of the serum bilirubin decreased significantly at 24 hours after exchange transfusion. [Conclusions] The simultaneous exchange transfusion with peripheral artery and vein can rapidly degrade the level of serum bilirubin, and also can improve internal environment. The therapy is characterized by rapid effect, few adverse effect and convenient operation, which deserve spreading its clinical application.