换血疗法对新生儿黄疸生化指标及血液内环境的影响

Effects of Exchange Transfusion Therapy on Biochemical Indexes and Blood Internal Environment in Neonates with Jaundice

目的探究换血疗法对新生儿黄疸生化指标及血液内环境的影响。方法选取2010年1月-2016年12月我院新生儿病房收治并行换血治疗的新生儿黄疸患儿58例作为研究对象,比较58例新生儿黄疸患者换血治疗前后血清胆红素水平变化、生化指标变化(血钙、血钠、血钾、血糖)和血常规指标变化[白细胞计数(WBC)、红细胞计数(RBC)、血红蛋白(HGB)、红细胞压积(HCT)、血小板(PLT)]。结果换血治疗后,患儿血钙、血钠及RBC、HGB和HCT水平与治疗前比较无显著变化(P>0.05),总胆红素、间接胆红素、直接胆红素、血钾及WBC、PLT水平较治疗前显著降低,血糖水平较治疗前显著增加,差异均具有统计学意义(P<0.05)。结论换血疗法可以有效降低新生儿黄疸患儿血清胆红素水平,改善新生儿黄疸临床症状,但换血疗法对新生儿黄疸生化指标及血液内环境的影响较大,应严格控制换血指征,术后监测患儿生化指标和血常规指标变化。

Objective To investigate the effects of exchange transfusion therapy on biochemical indexes and blood internal environment in neonates with jaundice. Methods From Jan. 2010 to Dec.2016, a total of 58 neonates with jaundice treated in neonatal intensive care unit（NICU） of our hospital for exchange transfusion therapy were selected as the clinical objects. The changes of serum bilirubin level, biochemical indexes（blood calcium, blood sodium, blood potassium, blood sugar） and blood routine indexes [white blood cell count（WBC）, red blood cell count（RBC）, hemoglobin（HGB）, hematocrit（HCT）, platelet（PLT）] were compared before and after exchange transfusion therapy in 58 neonates with jaundice. Results After exchange transfusion therapy, there was no significant changes in the levels of serum calcium, blood sodium, RBC, HGB and HCT compared with those before therapy（P〉0.05）, and the levels of total bilirubin, indirect bilirubin, direct bilirubin, blood potassium, WBC and PLT were significantly lower than those before therapy while the level of blood sugar was significantly higher than that before therapy（P〈0.05）. Conclusion Exchange transfusion therapy whose effect on blood biochemical indexes and blood internal environment is great, can not only effectively reduce the serum bilirubin level of neonates with jaundice, but also improve the clinical symptoms of neonatal jaundice. Therefore, the indications of blood exchange should be strictly controlled, and the biochemical indexes and blood routine indexes of children should be monitored after operation.