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目的 分析不同输血干预对预防换血后贫血的疗效及对血液内环境的影响.方法 将2011年5月至2012年4月郑州大学第三附属医院64例换血治疗患儿随机分为研究组和对照组,均采用O型红细胞和AB型血浆(1U∶ 100 ml)的重组血,换血后分别给予不同量重组血输入(研究组20 ml/kg±速尿1 mg/kg,对照组15m l/ks),比较两组换血前后血清总胆红素置换率、红细胞(RBC)、血红蛋白(Hb)、红细胞比容(Hct)、血压、电解质及住院天数等指标的变化.结果 研究组与对照组胆红素置换率比较差异未见统计学意义(P=0.07).相对于对照组,研究组换血后红细胞、血红蛋白、红细胞压积升高,与换血前比较差异有统计学意义(P＜0.01),血压、血气、电解质变化差异未见统计学意义(P分别为0.55,0.71,0.19),住院时间明显缩短(P=0.03).结论 输血干预(20ml/kg)可显著预防单倍量重组血换血治疗后贫血的发生,对血液内环境无明显影响,且能明显缩短住院时间.“,”Objective To analyze the effect of additional transfusion on preventing anemia after exchange transfusion.Methods From May 2011 to April 2012 in the third affiliated hospital of Zhengzhou university;sixty-four newborn infants with hyperbilirubinemia,treated by exchange transfusion with mixed blood(AB type plasma 1U was mixed with O type red blood cell 100 ml),were randomly divided into two groups.Both of the two groups received the double exchange transfusion in accordance with 150-180 ml/kg.After exchange,33 patients in treatment group,received mixed blood transfusion with 20 ml/kg(total volume was 60 ml);31 patients in control group,received additional transfusion with 15 ml/kg(total volume was 45 ml).The indicators,which included the exchange rate of neonatal serum bilirubin,RBC,hemoglobin (Hb),hematocrit (Hct),blood pressure,the elctrocyte and gas analysis,were monitored before and after the exchange transfusion.Results The exchange rates of serum bilirubin of treatment group and control group were (43.26 ± 11.9) ％ and (50.19 ± 12.6) ％,respectively,there was no significant difference between the two groups(P =0.07).Contrast to the control group,the difference of RBC,hemoglobin and hematocrit between before and after exchange transfusion showed significant difference in the treatment group(P ＜ 0.05).The difference of electrolyte (such as K +,Ca2 +) and blood gas value between before and after the exchange transfusion were not significantly different (P ＞ 0.05).There was significant difference in hospitalization days [(8 ± 2) d vs (9 ± 3) d] between the two groups (P =0.03).Conclusions Additional transfusion (25 ml/kg) can significantly prevent anemia after the exchange transfusion.It has no impact on blood circulation in neonates and can sho.rten the hospital days.