摘要
目的 观察外周动静脉双管同步换血疗法治疗新生儿高胆红素血症的安全性、疗效及内环境的变化.方法 对32例新牛儿高胆红素血症患儿采用外周动静脉双管同步换血,术中监测生命体征,换血前后行血常规、血生化、肝功能、血糖等检查,并进行分析比较.结果 换血前后总胆红素、间接胆缸素的平均换出率分别为52.5%、51.7%,换血后血红蛋白较换血前升高（P＜0.05）,白细胞、血小板、血钾则显著降低（P＜0.01）,血糖有短时升高,但与之前比较差异无显著性（P＞0.05）,血钠、钙换血前后无明显变化.结论 经外周动静脉双管同步换血疗法治疗新生儿高胆红素血症疗效显著,尽管有内环境改变,如血生化异常、血小板减少症等,但可自我调节恢复.无明显并发症.其操作简单易行、疗效可靠.在对患儿进行生命体征及血液多项相关项目的 密切监测下进行是安全的.
Objective To observe the safety, curative effect and variation of internal environment of treatment for neonatal hyperbilirubinemia by exchange transfusion of peripheral arteriovenous. Methods Exchange transfusion was performed through the peripheral vessels on 15 cases of hyperbilirubinemia. The blood routine, blood biochemical test, hepatic function and serum glucose were measured before and after exchange transfusion. And the results were analyzed and compared. Results The rate of exchange to bilirubin （TSB）, indirect bilirubin （IBIL） before and after exchange transfusion were 52.5% and 51.7% respectively. The hemoglobin after exchange transfusion was much higher than that before exchange transfusion （P〈0.05）, white blood cell, platelet and potassium were significantly lower （P〈0.01）, serum glucose might be increased sometime, but without statistic significant difference. The Na＋ and Ca2＋ had no obvious change before and after exchange transfusion. Conclusion Exchange transfusion of peripheral arteriovenous for neonatal hyperbilirubinemia treatment is safely effective with simple operation, although there were internal environment changes such as blood biochemical test abnormal, plate-reduction, but they could recover through self-adjustment and there was no obvious complication. The treatment was safe with the vital signs and blood related projects monitoring.
出处
《国际医药卫生导报》
2011年第14期1678-1681,共4页
International Medicine and Health Guidance News
基金
梅州市科技局科技计划项目立项科研课题
关键词
新生儿溶血病
高未结合胆红素
同步换血
Hemolytic disease of the newborn
High unconjugated bilirubin
Bilirubin encephalopathy synchronization exchange transfusion
