外周动静脉同步换血治疗新生儿重症溶血症

目的 :观察外周动静脉同步换血治疗新生儿重症溶血症的疗效。方法 :对确诊为溶血症的 3 1例患儿采用留置针穿刺 ,外周静脉输血 ,桡动脉抽血 ,同步进出速度 90～ 15 0ml/h ,配血量 160～ 180ml/kg(其中 10～ 15ml/kg为换血后输血用 ) ,换血前后监测胆红素、电解质、血常规。结果 :换血前总胆红素 44 8 86± 5 7.5 8μmol/L、间接胆红素 412 46± 15 6.3 8μmol,换血后分别为 2 0 7 5 4± 2 1 87μmol/L、183 72± 65 2 4μmol/L ,有显著性差异 (P <0 .0 5 ) ,血红蛋白换血后较换血前显著升高 (P <0 .0 1) ,电解质钾、钠、氯、钙无显著性差异 (P >0 .0 5 )。结论 :外周动静脉同步换血治疗新生儿重度溶血症 ,简单、易行、疗效可靠 ,无明显并发症 ,值得推广

The effect of exchange transfusion by peripheral artery and vein on hemolytic disease of the newborn

Objective: To observe the effect of exchange transfusion by peripheral artery and vein on hemolytic disease of the newborn.Methods: 31 cases of newborn with hemolytic disease were exchange transfusion by using the catheter inserted into a vein for infusion and a artery withdraw blood.The simutanious in out speed was 90 150 ml/h and the amount of prepared blood was 160 180 ml/kg(of which 10 15 ml/kg for infusion after exchange transfusion).Total bilirubin,serum K +,Na +,Cl ,Ca 2+ and blood routine were measured before and after transfusion.Results: Total bilirubin and indirect bilirubin were significantly decreased after transfusion( P<0.01) ,from 448.86±57.68 μmol/L,412.46±156.38 μmol/L,to 207.54±21.87 μmol/L,183.72±65.24 μmol/L respectively.Hemoglobins were significantly increased after exchange transfusion( P< 0.01). No apparent change occurred in serum K +,Na +,Cl ,Ca 2+ .Conclusion: The treatment effect of exchange transfusion by peripheral artery and vein were simple,easy,reliable and had no apparent complication.It is worthy of popularizing.