全自动同步换血治疗新生儿高胆红素血症12例临床分析

Clinical effect of automated synchronous exchange transfusion in the treatment of 12 neonates with hyperbilirubinemia

目的探讨外周动静脉全自动同步换血治疗新生儿高胆红素血症的疗效及对内环境的影响。方法对12例患儿采用外周动静脉穿刺,形成输入及排出回路,并检测患儿换血前后血清胆红素、血常规及血生化指标,并形成分析比较。结果 12例患儿经换血治疗后,血清总胆红素及间接胆红素明显下降(P<0.01),血糖升高(P<0.01),白细胞和血小板下降(P<0.01),钾+下降(P<0.05),红细胞、血红蛋白、钠、氯、钙、尿素氮、肌酐在换血前后变化差异均无统计学意义(P>0.05)。结论外周动静脉全自动同步换血疗法能明显降低血清总胆红素及间接胆红素水平,疗效显著,但对内环境有一定影响,需密切监测术后血常规和血生化的改变,注意术后感染和出血的出现。

Objective To investigate the clinical effect of automated synchronous exchange transfusion in peripheral vessels for treating neonates with hyperbilirubinemia,and its influence on the internal environment of neonates.Methods Twelve neonates with hyperbilirubinemia were treated by peripheral arteries and veins puncture.The blood routine,electrolytes,glucose,urea nitrogen,and creatinine were measured before and after exchange transfusion.Results After treatment,the levels of serum total bilirubin and indirect bilirubin decreased significantly（P〈0.01）,with glucose increased significantly（P〈0.01）,leukocytes and platelets decreased significantly（P〈0.01）,and serum potassium decreased significantly（P〈0.05）.The levels of hemoglobin,serum sodium,chlorine,calcium,urea nitrogen,and creatinine after treatment showed no statistically significant difference with that before treatment（P〉0.05）.Conclusion Exchange transfusion can significantly reduce the levels of serum total bilirubin and indirect bilirubin,but also exert influence on the internal environment.Thus,blood routine examination and blood biochemistry test should be performed after treatment,and infection and bleeding after treatment should be paid attention to.