摘要
目的观察不同剂量换血对ABO溶血导致新生儿高胆红素血症的疗效及对血液指标的改变的影响。方法收集2013年6月-2020年5月在宁夏医科大学总医院和银川市妇幼保健院收治的81例确诊为新生儿ABO溶血病、新生儿高胆红素血症的足月新生儿,采用随机数字表法分为A组、B组和C组,每组27例。三组分别给予3∶1重组血换血治疗,换血量分别为单倍量、双倍量、三倍量。比较换血前后血清总胆红素、白细胞、血红蛋白、血小板、血糖、平均动脉压、心率、电解质(钾、钠、氯、钙)、血清白蛋白,分析三组患儿二次换血比例。结果与换血前比较,换血后血清总胆红素、白细胞、血小板、血清白蛋白、血清钠离子、平均动脉压下降,血糖、心率升高(P<0.05);换血前后血清氯离子、血清钙离子、血清钾离子及血红蛋白比较,差异无统计学意义(P>0.05);换血后三组血清总胆红素、白细胞、血小板、血清钠离子、血清白蛋白、平均动脉压由高到低依次为A组、B组、C组,血糖和心率由高到低依次为C组、B组、A组(P<0.05),但三组血红蛋白、血清钾离子、血清氯离子、血清钙离子水平比较,差异无统计学意义(P>0.05);A组二次换血占比高于C组(P<0.05)。结论使用双倍量换血能有效降低由ABO溶血导致新生儿高胆红素血症的血清胆红素值,并能降低再换血比例,三倍量后并未减少二次换血比例。
Objective To observe the efficacy of different blood exchange volumes in the treatment of neonatal hyperbilirubinemia caused by ABO hemolysis and its influence on blood indexes.Methods A total of 81 full-term newborns diagnosed with ABO hemolytic disease and neonatal hyperbilirubinemia from June 2013 to May 2020 were collected in the General Hospital of Ningxia Medical University and Yinchuan Maternal and Child Health Hospital.They were divided into three groups(A,B and C)by random number table method,with 27 in each group.The three groups were treated with 3∶1 recombinant blood exchange,and the blood exchange volume was single,double and triple.Serum total bilirubin,white blood cells,hemoglobin,platelet,blood glucose,mean arterial pressure,heart rate,electrolyte(potassium,sodium,chlorine,calcium)and serum albumin were compared before and after blood exchange,and the proportion of secondary blood exchange in the three groups was analyzed.Results Compared with before blood exchange,serum total bilirubin,white blood cells,platelets,serum albumin,serum sodium ion,mean arterial pressure decreased,blood glucose and heart rate increased after blood exchange(P<0.05).There was no significant difference in serum chloride ion,serum calcium ion,serum potassium ion and hemoglobin before and after blood exchange(P>0.05).After blood exchange,the serum total bilirubin,white blood cells,platelets,serum sodium ion,serum albumin and mean arterial pressure in the three groups from high to low were group A,group B and group C,and the blood glucose and heart rate from high to low were group C,group B and group A(P<0.05),but there was no significant difference in hemoglobin,serum potassium,serum chloride and serum calcium among the three groups(P>0.05).The proportion of secondary blood exchange in group A was higher than that in group C(P<0.05).Conclusion Double blood exchange volumes can effectively reduce the serum bilirubin value of neonatal hyperbilirubinemia caused by ABO hemolysis,and can reduce the proportion of re-blood exchange.The proportion of secondary blood exchange volume does not decrease after triple blood exchange volumes.
作者
许风芝
张红桃
王永明
马利勇
XU Feng-zhi;ZHANG Hong-tao;WANG Yong-ming;MA Li-yong(Department of the Neonate,General Hospital of Ningxia Medical University,Yingchuan 750001,Ningxia,China;PICU,Ningxia Children's Hospital,Yingchuan 750001,Ningxia,China;Department of the Neonate,Yinchuan Maternal and Child Health Care Hospital,Yingchuan 750001,Ningxia,China)
出处
《医学信息》
2021年第20期115-118,共4页
Journal of Medical Information
关键词
换血
新生儿ABO溶血病
新生儿高胆红素血症
Exchange transfusion
ABO hemolytic disease of newborn
Neonate hyperbilirubinemia
作者简介
许风芝(1986.2-),女,宁夏吴忠人,本科,主治医师,主要从事新生儿感染及新生儿黄疸疾病的治疗研究。
