摘要
目的 探讨换血疗法治疗新生儿高胆红素血症的临床效果。方法 选取2016年1月至2018年1月亳州市人民医院收治的56例新生儿高胆红素血症患儿为研究对象,采用外周动静脉同步换血疗法进行治疗,观察患儿换血前后常见血液指标、胆红素水平变化以及不良反应发生率。结果 换血后血清胆红素和间接胆红素水平明显低于换血前[(205±91)μmol/L比(403±105)μmol/L、(180±76)μmol/L比(349±116)μmol/L](P<0.05);换血后患儿血小板计数明显低于换血前[(68±5)×10^9/L比(210±18)×10^9/L],血红蛋白水平明显高于换血前[(136±10)g/L比(92±7)g/L](P<0.05);换血前后患儿血液电解质Na^+、K^+、Ca^2+水平比较差异无统计学意义(P>0.05)。换血前后凝血酶原时间、活化部分凝血活酶时间、纤维蛋白原比较差异无统计学意义(P>0.05)。患儿治疗期间及治疗后血压、心率均未发生明显变化,在正常范围内波动,且所有患儿均未发生不良反应。结论 换血疗法治疗新生儿高胆红素血症可快速有效地降低患儿的胆红素水平,操作简单,不良反应发生率低。
Objective To explore the clinical efficacy of blood exchange therapy in the treatment of neonatal hyperbilirubinemia. Methods A total of 56 newborn children with high blood bilirubin in Bozhou People′s Hospital,from Jan. 2016 to Jan. 2018 treated with peripheral artery and vein of synchronous exchange transfusion treatment were included in the study.The blood indexes,bilirubin level and incidence of adverse reactions were observed before and after treatment. Results The levels of serum bilirubin and indirect bilirubin after blood exchange were significantly lower than those before[(205±91)μmol/L vs(403± 105)μmol/L,(180±76)μmol/L vs(349±116)μmol/L]( P <0.05).The platelet count was significantly lower than that before the exchange[(68±5)×10^9/L vs (210±18)×10^9/L],and the hemoglobin level was significantly higher than that before the exchange[(136±10) g/L vs (92±7) g/L]( P < 0.05).There was no significant difference in blood electrolyte Na^+,K^+,Ca^2+ level between before and after the blood exchange.There was no significant difference in prothrombin time, activated partial thromboplastin time and fibrinogen before and after the blood exchange ( P >0.05).There were no significant changes in blood pressure and heart rate during and after treatment,all fluctuating within the normal range,and no adverse reactions occurred in all children. Conclusion The treatment of neonatal hyperbilirubinemia by blood exchange therapy can rapidly and effectively reduce the index of bilirubin in children with simple operatation and low incidence of adverse reactions.
作者
徐承琴
白婧
魏广友
XU Chengqin;BAI Jing;WEI Guangyou(Department of Pediatrics,Bozhou People′s Hospital,Bozhou 236800,China)
出处
《医学综述》
2019年第16期3313-3316,共4页
Medical Recapitulate
关键词
新生儿高胆红素血症
换血治疗
凝血
Neonatal hyperbilirubinemia
Blood exchange therapy
Blood coagulation
