换血疗法治疗重症新生儿高胆红素血症的临床研究

Clinical research on exchange transfusion therapy in the treatment of neonates with severe hyperbilirubinemia

目的探讨外周动静脉同步换血疗法治疗新生儿重症高胆红素血症的可行性及临床应用效果。方法对20例患儿采用外周动静脉同步换血的方法置换出体内1.5～2.0倍的血量,监护生命体征,换血前后查血常规、肝功能、电解质等。结果患儿平均换血量达173.08mL/kg,换血后患儿总胆红素、间接胆红素、直接胆红素、血常规、Na+明显下降(P﹤0.05),K+、Ca2+、Glu以及凝血功能在换血前后差异均无统计学意义(P>0.05),且随访过程中未出现神经系统后遗症等并发症。结论外周动静脉同步换血疗法具有简单、安全、实用的优点,且疗效显著,值得临床推广。

Objective To investigate the feasibility and clinical application on exchange transfusion therapy of peripheral arteriovenous synchronous in the treatment of neonates with severe hyperbilirubinemia. Methods Twenty patients were treated by peripheral arteriovenous synchronous exchange transfusion method in order to replace the blood in body of 1.5~ 2.0 times, the vital signs was detected, complete blood count, liver function, electrolytes were detected before and after exchange transfusion. Results The average blood volume of children was 173.08 mL/kg, the total bilirubin, indirect bilirubin, direct bilirubin, blood routine, Na＋ was significantly decreased after the exchange transfusion （P 〈 0.05）, K＋, Ca2＋, Glu and coagulation function had no significant differences before and after exchange transfusion （P 〉 0.05）, there was no neurological sequelae and complications in the follow-up process. Conclusion Peripheral arteriovenous synchronous exchange transfusion therapy is simple, safe, practical, and has obvious curative effect, so it is worthy of clinical application.