不同血源对ABO溶血病外周动静脉同步换血疗效的比较

Comparision of the curative effect of exchange transfusion used different type donor blood via peripheral vessels on ABO hemolytic disease

目的 探讨不同血源对ABO溶血病外周动静脉同步换血的疗效。方法 对 2 3例ABO溶血病患儿依时间分为二组 ,同型血组和混合血组。同型血组采用与患儿血型相同的血为血源换血 ,混合血组采用AB型血浆和O型洗涤红细胞混合血为血源换血。换血途径均采用外周动静脉。结果 同型血组和混合血组换血后总胆红素下降显著 ,4 50 0± 1 4 4 2 4 μmol/L ,2 54 56± 87 58μmol/L ,393 4 8± 1 6 7 4 6vs2 36 6 0± 97 79μmol/L ;两组的换出率分别是 :4 2 2 5± 1 3 91 % ,38 4 6± 1 3 1 6 % ,t =0 70 ,P >0 0 5。换血后两组的血细胞 ,红细胞压积 (HCT) ,电解质 ,白蛋白改变相同。换血后无明显不良反应。结论 同型血和混合血为血源换血疗效相同 ,在紧急情况下采用同型血换血可以节约时间。

Objective To investigate the curative effect of exchange transfusion with different type donor blood via peripheral vessels on ABO hemolytic disease. Methods 23 cases of ABO hemolytic disease were divided into the hemolytic blood group and the mixed blood group. The hemolytic blood group exchange transfusion used the same type whole blood of the infant′s ABO blood type. The mixed blood group exchange transfusion used the AB type plasma mixed with the O type RBCs. Exchange transfusion were performed through the peripheral vessels on all of the 23 cases. Results Total bilirubin(T Bili) and Indirect bilirubin(I Bili) were markedly decreased in two groups after exchange transfusion( P <0.001). Before and after the concentration of T Bili were 450.0±144.24 μmol/L vs. 254.56±87.58 μmol/L, 393.48±167.46 vs. 236.60±97.79 μmol/L, respectively. The T Bili clearance rates of two groups were 42.25±13.91%, 38.46±13.16%, t=0.70, P>0.05 . The changes of blood cells, HCT, electrolytes and albumin were identically. After exchange transfusion there was few complication. Conclusion The curative effect of exchange transfusion of homotypic blood or the mixed blood via vessels on ABO hemolytic disease infant was similar. In the critical moment exchange transfusion used homotypic blood can save time.