211例新生儿重症高胆红素血症换血治疗的临床分析

Clinical analysis of 211 cases of neonatal severe hyperbilirubinemia with exchange transfusion therapy

目的:探讨采用换血疗法治疗新生儿重症高胆红素血症的效果、不良反应及相关影响因素。方法:回顾性分析2006年1月—2019年12月汕头大学医学院第二附属医院采用换血治疗的211例重症高胆红素血症新生儿的临床资料,其中男性113例,女性98例。结果:换血后血清总胆红素、间接胆红素、白细胞、血小板计数较换血前降低,差异均有统计学意义(P<0.001)。换血后不良反应主要是血小板减少(6.6%)和白细胞减少(6.2%)。胎龄越小,体重越低或合并其他疾病时,换血时不良反应的发生率越高(P<0.05)。结论:换血疗法能迅速清除新生儿血中胆红素,是重症高胆红素血症的一种安全有效的治疗手段。换血治疗需要细致处理,以减少不良反应的发生。

Objective:To investigate the effect,adverse reactions and related influencing factors of using exchange transfusion therapy to treat severe hyperbilirubinemia in newborns.Methods:The clinical data of 211 neonates with severe hyperbilirubinemia treated with blood exchange in the Second Affiliated Hospital of Shantou University Medical College from January 2006 to December 2019 were retrospectively analyzed,including 113 males and 98 females.Results:Serum total bilirubin,indirect bilirubin,leukocyte,and platelet counts decreased after blood exchange compared with those before blood exchange,and the differences were statistically significant(P<0.001).The main adverse reactions after blood exchange were thrombocytopenia(6.6%)and leukopenia(6.2%).The younger the gestational age,the lower the weight or the combination of other diseases,and the higher the incidence of adverse reactions during exchange transfusion(P<0.05).Conclusion:Exchange transfusion therapy can quickly remove bilirubin in the blood of newborns and is a safe and effective treatment for severe hyperbilirubinemia.Transfusion therapy requires meticulous treatment to reduce the occurrence of adverse reactions.