新生儿ABO溶血病425例早期诊治的启示

目的:探索新生儿ABO溶血病的好、简、廉的治疗方法。方法:总结分析该院15年来对425例新生儿ABO溶血病早期诊断和早期以加强光疗为主治疗的效果、副作用和疾病转归,探讨本病适宜的治疗方法。结果:光疗过程中全部病例的平均血清胆红素峰值被控制在(240±48.1)μmol/L(x±s),88%的病例被控制在255μmol/L以下,99%的病例被控制在340μmol/L以下。无1例需要换血,无1例发生胆红素脑病和死亡,罕见副作用,最后全部治愈。平均住院(5.4±0.8)天。结论:早期诊断和早期加强光疗可减少和避免换血和不必要的静脉应用大剂量丙种球蛋白。目前对本病的"过度治疗"倾向应予防止。

The enlightenment from early diagnosis and early phototherapy on 425 cases with neonatal ABO incompatibility

Objective:To search for the best,more convenient and cheaper therapy for neonatal ABO incompatibility.Methods:The effects,side-effects and results of early diagnosis and early intensive phototherapy on 425 cases with neonatal ABO incompatibility during last 15 years were summarized and analyzed to explore the suitable therapy for this disease.Results:During phototherapy,the average peak serum bilirubin level of all cases was controlled at(240+48.1)μmol/L,among the 425 cases,88% were controlled bellow 255 μmol/L and 99% bellow 340 μmol.None needed exchange transfusion,none bilirubin encephalopathy or death occurred,the side-effects were rare.All the eases were cured.The average hospitalization period was(5.4±0.8)d.Conclusion:Early diagnosis and early intensive phototherapy can minimize the need for exchange transfusion or high-dose gamma globulin.The current tendency of excess treatment for this disease should be prevented.