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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。
Objective To investigate the efficacy and safety of peripheral arterial and venous blood exchange in the treatment of neonatal severe hyperbilirubinemia. Methods Eleven neonates with hyperbilirubin were transplanted peripherally and venously simultaneously. O-type and AB-type plasma were used to wash erythrocytes and plasma. The ratio of erythrocytes to plasma was 2 ~ 3: 1. The vital signs , Monitoring bilirubin levels in children before and after changing blood, and changes in blood electrolyte indicators. Results After transfusions, serum total bilirubin and indirect bilirubin levels were significantly lower than those before transfusions, the difference was statistically significant (P <0.01). Platelet exchange transfusion decreased significantly, the difference was statistically significant (P <0.05), hemoglobin significantly higher than before the exchange of blood, the difference was statistically significant (P <0.05). Before and after the exchange of blood, the change in leukocytes was not statistically significant, no changes in serum sodium, potassium and calcium. Conclusion For children with severe hyperbilirubinemia, transfusions should be carried out as soon as possible to rapidly reduce the level of bilirubin in the body and to monitor the vital signs of children closely. After transplanting the blood, we should pay attention to monitoring the blood routine and Electrolyte changes prevent infections, bleeding and electrolyte disturbances.