【摘要】 目的探讨外周动、静脉同步换血法治疗新生儿重度高胆红素血症的疗效及安全性。方法 11例新生儿高胆红素患儿进行外周动、静脉同步换血,采用O型洗涤红细胞和AB型血浆,洗涤红细胞与血浆的比例为2～3:1,换血过程中监测各项生命体征,换血前后监测患儿胆红素水平,及血常规电解质指标的变化。结果换血后血清总胆红素水平和间接胆红素水平较换血前均有明显降低,差异有统计学意义(P<0.01)。血小板换血后明显下降,差异有统计学意义(P<0.05),血红蛋白较换血前明显升高,差异有统计学意义(P<0.05)。换血前后,白细胞变化差异无统计学意义,血钠血钾血钙无明显变化。结论对于重症高胆红素血症患儿,应尽早进行换血治疗,可快速降低体内胆红素水平,并严密监测患儿的各项生命体征,换血后应注重监测患儿的血常规和电解质变化,预防感染、出血和电解质紊乱的发生。更多还原

【Abstract】 Objective To investigate the efficacy and security of peripheral arteriovenous synchronous exchange transfusion therapy on patients with neonatal hyperbilirubinemia.Methods 11 cases neonatal hyperbilirubinemia patients were applied by peripheral arteriovenous synchronous exchange transfusion.O washed red blood cells and AB plasma transfusion were used at the ratio of 2～3:1,monitoring vital signs.The levels of bilirubin,routine blood test and electrolyte analysis before and after blood exchange were detected and compared.Results Serum total and indirect bilirubin levels were significantly decreased after the exchange(P<0.01).Platelet decreased obviously with significant difference(P<0.05),while hemoglobin was higher(P<0.05).No significant changes were found in white blood cell,serum sodium,potassium,calcium levels.Conclusion Blood exchange plus transfusion should be carried out as soon as possible to reduce blood bilirubin levels in newborn with severe hyperbilirubinemia.Meanwhile it’s important to monitor patients vital signs,blood and electrolyte changes,in order to prevent the occurrence of infection,bleeding and electrolyte disorder.更多还原