人血白蛋白和人丙种球蛋白治疗新生儿溶血的临床效果

Clinical effect of human albumin and human normal immunoglobulin in the treatment of neonatal hemolysis

目的:探讨人血白蛋白和人丙种球蛋白治疗新生儿溶血的临床效果。方法:对2014年4月至2015年4月本院收治的128例溶血新生儿进行药物治疗,根据治疗药物不同分为试验组和对照组(各64例),对照组采用常规方法治疗(保持水电解质平衡,供给足够能量,维持体温正常,改善循环功能),试验组行人血白蛋白(注射5 g,直到血清白蛋白含量恢复正常)及人丙种球蛋白(1 g·kg-1,于4~6 h静脉滴注,用1次即可)结合治疗,观察两组患儿的临床效果,治疗前和治疗3 d后总胆红素含量,以及治疗1个月的红细胞计数、血红蛋白含量、黄疸消退的时间。结果:试验组的总有效率(96.9%)明显高于对照组(79.7%),差异具有统计学意义(P<0.05);两组患儿治疗3 d后的总胆红素含量、红细胞计数、血红蛋白含量与治疗前均存在明显差异(P<0.05);试验组患儿治疗后的总胆红素含量、红细胞计数、血红蛋白含量与对照组存在明显差异(P<0.05);试验组黄疸消退时间为(4.1±0.9)d,明显短于对照组的(6.9±0.8)d,差异具有统计学意义(P<0.05)。结论:将人血白蛋白和人丙种球蛋白应用于新生儿溶血可有效地改善患儿的总胆红素含量、红细胞计数、血红蛋白含量,缩短黄疸消退时间。

Objective： To study the clinical effect of human albumin and human normal immunoglobulin in neonatal hemolysis. Methods ：From April 2014 to April 2015,128 cases of hemolytic disease of the newborn in our hospital, according to different drug treatment, were divided into experimental group and control group （n = 64 cases） , the control group treated by conventional methods （maintaining water electrolyte balance and normal body temperature,improving circulation function） , experimental group （injecting human albumin of 5 g till serum albumin protein levels returned to normal） and human human normal immunoglobulin （1 g ·kg^-1 ,4-6 h intravenous drip） combined treatment. Clinical effects were observed before and 3 days after treatment, including total bilirubin levels and red blood cell count and hemoglobin content and jaundice disappearance. Results： The total effective rate （96.9%） of the experimental group was significantly higher than that of the control group （79.7%） with a significant difference （ P 〈 0. 05 ） ; after treatment, the total bilirubin levels, erythrocyte count, hemoglobin content of the two groups and before treatment had obvious difference （ P 〈 0. 05 ） ; and the total bilirubin levels, erythrocyte count, hemoglobin content of experimental group and control group had obvious difference （ P 〈 0.05 ） ; The jaundice subsiding time （4.1 ± 0.9 ） d of experimental group was significantly shorter than that of the control group （6.9 ± 0.8 d）,with significant difference （P 〈0.05）. Conclusion：Human serum albumin and human normal immunoglobulin protein used in hemolytic disease in newborns can effectively improve the total bilirubin content, red blood cell count, hemoglobin content and jaundice quickly.