换血联合丙种球蛋白治疗新生儿溶血症的临床效果

Clinical Effect of Exchange Blood Transfusion Combined with Gamma Globulin on Neonatal Hemolysis

目的探讨换血联合丙种球蛋白治疗新生儿溶血症(HDN)的临床效果。方法选取HDN患儿78例,按随机数字表法分为2组:对照组39例,予以丙种球蛋白治疗;观察组39例,在对照组治疗基础上加用换血疗法。比较2组症状改善时间(黄疸消退时间、光疗时间、住院时间)、血生化指标[血清胆红素(TBIL)、红细胞(RBC)及血红蛋白(Hb)含量]、神经行为能力(NBNA)评分、并发症及不良反应发生情况。结果与对照组比较,观察组黄疸消退时间、光疗时间、住院时间均显著缩短(均P<0.05);与治疗前比较,2组血清TBIL水平显著下降、RBC及Hb含量显著升高,且观察组治疗后上述指标变化更为明显(均P<0.05);与对照组比较,观察组治疗后NBNA评分显著升高,并发症发生率显著下降(均P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论换血联合丙种球蛋白治疗HDN,可以显著降低血清TBIL水平,提高RBC、Hb含量,快速改善症状,减少神经系统、脑组织损伤,改善预后。

Objective To explore the clinical effect of exchange blood transfusion combined with gamma globulin on hemolytic disease of the newborn(HDN).Methods Seventy-eight cases of HDN were randomly treated with gamma globulin alone(control group,39 cases)or in combination with exchange blood transfusion(observation group,39 cases).Jaundice regression time,phototherapy time,hospital stay,levels of serum total bilirubin(TBIL),red blood cell(RBC)and hemoglobin(Hb),neonatal behavioral neurological assessment(NBNA)score,complications,and adverse reactions were compared between the two groups.Results The jaundice regression time,phototherapy time and hospitalization time in the observation group were shorter than those in the control group(P<0.05).After treatment,the concentration of TBIL decreased and the levels of RBC and Hb increased in both groups,and the changes in the observation group were more obvious than those in the control group(P<0.05).Compared with the control group,the score of NBNA increased and the incidence of complications decreased in the observation group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Exchange blood transfusion combined with gamma globulin can decrease TBIL content,increase RBC and Hb levels,improve symptoms,reduce damage of nervous system and brain tissue,and improve prognosis in children with HDN.