双周围静脉同步换血疗法在儿科临床应用体会

Experience of Synchronous Exchange Transfusion Thrapy by Double Peripherd Veins in Pediatric Clinical

目的：为了探讨双周围静脉同步换血疗法在儿科临床应用的价值。方法：选择新生儿溶血症所致的高间接胆红素血症、新生儿败血症及药物中毒患儿，开放两条周围静脉，选用血型相同、配血不凝集的3d内的构橼酸钠抗凝全血为血源，从一条静脉抽血（或持续滴放），同时从另一条静脉用枸橼酸血持续输入，抽血、输血同步进行，2～4h完成。结果：新生儿溶血症换血后血清总胆红素及间接胆红素明显下降，新生儿败血症患儿换血后，血小板明显上升，白细胞数明显降低，感染中毒症状明显减轻。结论：研究表明，双周围静脉同步换血疗法疗效确切、安全，操作方法简便，不受年龄、体重及血流量的影响，在基层医院有较好的推广应用价值。

Objective：To explore the clinical use value of synchronous exchange transfusion thrapy by double peripherd veins in pediatric clinical. Methods： Patients of hyperebilirubinemia by neonates hemolyze, of nenoates septiceywia and of toxicosis medicinalis were selected. In the course of the transfusion, two scalp veins of neonatal and two limb veins of other age -specific patients were selected, The hemospasia blood source was the same hemotype whole blood in three days, which was anticoagulant by natrium citricum at the beginning of syn- chronous exchange transfusion, In the meanwhile,venous transfusion was to be given at the same speed with na-trium blood, The whole process was accomplished within 2--4 hours. Result： After the exchange transfusion, the serum total bilirubin and the indirect bilirubin were evidently decreased in the hemolyses.Platetets were increased and white blood cells were evidently decreased in neouatal septicemia. The infection toxication symptoms were obviously lessened. Conclusion： Synchronous exchange transfusion thrapy by double peripherd veins was safe, efficient and feasible, which was not affected by ages, avoirdupois and volumes of bloodstream. It can be pro-moted in the substrate hospitals.