新生儿Rh溶血病不同血源换血疗法的疗效观察

A study on the therapy of exchange transfusion with different type of donor blood in the newborn with Rhesus incompatibility hemolytic disease

目的:探讨新生儿 Rh溶血病实行换血疗法时的血源选择和换血量的确定。方法 :选取在我院接受换血治疗的 6 3例 Rh溶血病患儿 ,其中用 Rh阳性血换血 32例 ,Rh阴性血换血 31例 ,分析其换血前后血清总胆红素(TB)和血红蛋白 (Hb)变化以判断疗效。 结果 :两种换血术均获得满意疗效 ,换血后胆红素值明显下降 ,所有患儿均痊愈出院。 结论 :在紧急情况下 ,若无法及时得到 Rh阴性血 ,可用 Rh阳性血换血 ,换血量至少应 >2 0 0 m l/ kg(为 Rh阴性血的 2倍 ) ,若应用得当 。

Objective: To explore the determine of the type and the volume of the donor blood in the therapy of exchange transfusion in the newborn with Rhesus incompatibility hemolytic disease. Methods: 63 cases of newborn with Rhesus incompatibility hemolytic disease were studied, including 29 cases who were treated by Rhesus negative blood as the donor blood and 34 cases treated by Rhesus positive blood. Their blood bilirubin and hemoglobin were analyzed in order to find the effective method. Results: Therapy of the two groups are all effective, their bilirubin level were decreased significantly after exchange transfusion. All patients got fully recover. Conclusion: In emergency when there are no Rhesus negative blood can be provided in time, Rhesus positive blood can be used as a replacement , if only been used appropriately and the volume of the donor blood to be used should be above the lever of 200 ml per kg body weight.