新生儿溶血病与胆红素脑病的诊治分析

目的:探讨新生儿溶血病及胆红素脑病二者之间关系。方法:2002年1月～2010年12月,回顾性分析在我院确诊的新生儿溶血病患儿128例及胆红素脑病患儿27例的临床资料,其中新生儿溶血病中ABO血型不合96例,Rh血型不合32例,应用χ2检验二组中胆红素脑病、换血治疗及B/A平均比值。结果:27例发生胆红素脑病患儿中,26例为Rh溶血(96.3%),1例为ABO溶血(3.7%),二者有显著差异(P<0.001),37例换血患儿中25例为Rh溶血(78.1%),12例为ABO溶血(21.9%),二者有显著差异(P<0.001),Rh溶血B/A平均比值为5.48±0.02,ABO溶血B/A平均比值为2.20±0.018,二者有显著统计学差异(P<0.001)。结论:Rh溶血患儿发生胆红素脑病、换血概率高于ABO溶血,胆红素/白蛋白比值(B/A)可作为评估胆红素毒性的危险因素。

Analysis of Diagnosis and Treatment on Hemolytic Disease of Newborns and Bilirubin Encephalopathy

Objective Understanding the relationship between hemolytic disease of the newborn and bilirubin encephalopathy Method From of January 2006 to December 2010,128 patients are diagnoesed hemolytic disease of the newborn and 27 patients are diagnosis bilirubin encephalopathy,in which 96 cases are ABO hemolytic disease,32 cases are Rh hemolytic disease.χ2 test in two groups of bilirubin encephalopathy,exchange transfusion and bilirubin/albumin ratio of mean。Result 27 patients are diagnosis bilirubin encephalopathy,26 are Rh hemolytic disease,Prevalence rate was 96.3%,1 is ABO hemolytic disease Prevalence rate3.7%,both are significantly different(P<0.001),In 37 cases of blood transfusion in cases,Rh hemolysis are 25 cases,ABO hemolysis are 12 cases in pediatric patients,both are significantly different(P<0.001).RH hemolysis in neonates with bilirubin/albumin is 5.48±0.02,ABO hemolysis in neonates with bilirubin/albumin is 2.20±0.018,both are significantly different(P<0.001).Conclusion Rh hemolytic disease more susceptible to bilirubin encephalopathy and blood transfusion,bilirubin/albumin can be Risk factors of bilirubin encephalopathy