不同球浆比组分血换血治疗新生儿高胆红素血症的疗效比较

Exchange transfusion in neonatal hyperbilirubinaemia: a comparison between citrated whole blood and different ball-oplasm ratio reconstituted blood

目的比较全血和组分血换血疗法治疗新生儿高胆红素血症的效果。方法回顾性分析新生儿高胆红素血症经换血治疗的临床资料。根据换血时的血球、血浆组分,分为球浆比1:1换血疗法组(1:1组,n=18)、球浆比2:1换血疗法组(2:1组,n=20)和全血换血疗法组(全血组,n=17)。结果三组患儿的人口学特征和黄疸病因的差异无统计学意义。ABO溶血是各组新生儿黄疸最常见的病因。各种换血疗法有效率的差异无统计学意义。2:1组患儿换血后血红蛋白和红细胞压积高于其他两组,差异有统计学意义(P<0.05);三组间换血后低钙血症和血小板减少症发生率的差异无统计学意义。结论血球和血浆比2:1组分血换血后,贫血发生率更低,更适合新生儿高胆红素的换血疗法。

Objective To determine the efifcacy of exchange transfusion （ECT） with whole blood and reconstituted blood in neonatal hyperbilirubinaemia. Methods The clinical data of hyperbilirubinaemic neonates who had undergone ECT was reviewed. The neonates were categorized into three groups based on their ECT, whole blood （n=17）, 1：1 ball-oplasm ratio reconstituted blood （n=18） and 2：1 ball-oplasm ratio reconstituted blood （n=20）. Results There was no signiifcant difference in the demographic characteristics and causes of jaundice among the three groups. ABO blood incompatibility was the most com-mon cause of hyperbilirubinaemia in all groups. ECT with reconstituted or whole blood had no signiifcant effect on biochemi-cal indices of serum in patients. The levels of hemoglobin and hematocrit of 2：1 ball-oplasm ratio group were higher than those of other groups （P〈0.05）. The rates of hypocalcaemia and thrombocytopenia were similar in three groups after ECT. Conclu-sion ECT with 2：1 ball-oplasm ratio reconstituted blood can reduce the occurrence of anemia, and is more effective to treat neonatal hyperbilirubinaemia.