外周动静脉同步换血治疗新生儿高胆红素血症49例疗效分析

Effect of Peripheral Arteriovenous Simultaneous Exchange Transfusion for the Treatment of Neonatal Hyperbilirubinemia

【目的】探讨外周动静脉同步换血治疗新生儿高胆红素血症临床疗效。【方法】对49例新生儿高胆红素血症临床迭换血标准的患儿采用外周动静脉同步换血治疗，比较换血前后血清胆红素、生化、血常规的变化。【结果】换血后总胆红素（TBili）与未结合胆红素（IBili）的换出率分别是49．2％、51．15％，换血前后比较差异有显著性（P〈0．01）；换血后K^＋、Na^＋、Cl^-、TCa^2＋、BE变化不大（P〉0．05）；换血前后血红蛋白（Hb）比较差异有显著性（P〈0．05）；换血后白细胞（WBC）和血小板（PLT）均显著下降；换血后血糖与换血前比较显著增高（P〈0．01）。【结论】外周动静脉同步换血治疗新生儿高胆红素血症疗效显著，不会引起致命性高钾血症，但可造成WBC和plat明显下降，应引起临床上重视。

[Objective] To discuss the effect of peripheral arteriovenous simultaneous exchange transfusion for the treatment of neonatal hyperbilirubinemia. [Methods]Forty nine cases of children were treated by peripheral arteriovenous simultaneous exchange transfusion with the standard of exchange transfusion. The changes of serum bilirubin, biochemistry, blood before and after the exchange transfusion were compared. [Resuits] After the exchange transfusion, the exchange rate of total bilirubin and unconjugated bilirubin were 49.2% and 51.15 %, respectively, and there were significant differences between before and after exchange transfusion （ P 〈0.01）. After the exchange transfusion, K^＋ , Na^＋ , Cl^- , TCa^2＋ and BE had little changes （ P 〉 0.05）. There was significant difference in Hb between before and after exchange transfusion （ P 〈 0. 05）. The WBC and plat were significantly decreased. After the exchange transfusion, blood sugar was significantly increased （ P 〈0.01）. [Conclusion] Peripheral arteriovenous simultaneous exchange transfusion is effective for the treatment of neonatal hyperbilirubinemia, and does not cause fatal hyperkalemia. But it can cause the decrease of WBC and plat which should be taken into account in clinics.