单倍与双倍循环血量换血治疗重度新生儿高胆红素血症

Treatment of Severe Neonatal Hyperbilirubinemia by Single or Double-volume Blood Transfusion

目的探讨应用单倍与双倍循环血量换血治疗重度新生儿高胆红素血症,分析单倍循环血量换血的可行性。方法将新生儿重症监护病房2011年1月至2016年9月收治的40例符合换血指征的重度新生儿高胆素血症患儿随机分为两组,每组20例,均采取外周动静脉同步全自动换血进行治疗。观察组采用单倍循环血量换血,对照组采用双倍循环血量换血,比较两组胆红素置换率的差异。结果两组换血后血总胆红素、间接胆红素均较换血前明显下降(P<0.05);胆红素置换率与换血量有一定相关性,但不呈比例增加;双倍循环血量换血胆红素置换率达(50.89±3.35)%,单倍循环血量换血为(49.12±2.73)%,差异无统计学意义(P=0.059)。结论单倍循环血量换血也可明显降低血胆红素,同时可减少内环境影响,降低换血并发症发生,值得推广。

Objective To investigate the treatment efficacy of severe neonatal hyperbilirubinemia by single or double-volume blood transfusion and analyze the feasibility of single-volume blood transfusion.Methods Forty neonatal with hyperbilirubinemia treated by automated peripheral arteriovenous transfusion according with blood transfusion indications were randomly divided into two groups in neonatal ICU ward from January 2011 to September 2016. Twenty cases of observation group were treated by single-volume blood transfusion,and the other twenty cases of control group were treated by the double-volume blood transfusion.Then,the difference of bilirubin exchange rate was compared in two groups. Results Total serum bilirubin and indirect bilirubin of the two groups after transfusion were significantly lower than those before transfusion（ P〈0. 05）;. bilirubin exchange rate had certain correlation with blood transfusion volume,but it increased disproportionately. The bilirubin exchange rate of the double-volume blood transfusion（ 50. 89 ± 3. 35） %.was slightly higher than the single-volume blood transfusion reached（ 49. 12 ± 2. 73） %,but there was no statistically significant difference（ P = 0. 059）. Conclusion Single-volume blood transfusion could also significantly decrease blood bilirubin. Meanwhile,it could reduce the influence of internal environment,decease complications,and be worth popularizing.