新生儿红细胞增多症47例临床分析

CLINICAL ANALYSIS OF 47 CASES OF NEONATAL POLYCYTHEMIA

本文报道新生儿红细胞增多症47例,病因:①宫内缺氧红细胞生成素增加(主动型):围产期窒息25例,小于胎龄儿12例,母患糖尿病及21-三体综合征各1例,②血容量增加(被动型):胎～胎输血7例,晚扎脐带1例。有症状的婴儿采用部分换血治疗(15～20ml/kg),尽快使红细胞压积降至0.60以下,本组部分换血22例,另25例经血浆、白蛋白,甚至生理盐水静脉稀释治疗,46例痊愈,仅1例早产儿治疗过晚死亡,病死率为2.1％,

This paper reports 47 cases of neonatal polycythemia admitted to our hospital. in 1990. The hemoglobin of all cases was greater than 220g/L and the veinous hematocrit more than 0.65. The causes of neonatal polycythemia may be divided into two major categories: I. Intrauterine hypoxia with increased erythropoiesis. (active form): Twenty five case were due to perinatal hypoxia and twelve cases were small for gestational age infants. 2.Increase of blood volume(passive form): Seven cases were due to twin-to-twin transfusion and only one case was because of delayed cord clamping. Treatment of infants with symptoms should be designed to reduce the venous hematocrit to less than 0.6 by partial plasma exchange transfusion. The formula for the volume of exchange is easy to be forgotten. It may be simplified as 15~20ml/kg. In this report 22 cases were treated by partial exchage transfusion, the other 25 cases were treated by transfusion of plasma or albumin, even N.S. Forty six cases were recovered, only one premature baby was dead with the mortality rate of 0.2%.