全自动外周动静脉同步换血疗法治疗重症新生儿高胆红素血症

目的:探讨全自动外周动静脉同步换血疗法治疗重症新生儿高胆红素血症的疗效及其安全性。方法:对52例采用全自动外周动静脉同步换血疗法的重症新生儿高胆红素血症患儿,比较分析其换血前后的生命体征、胆红素等生化指标、pH值及血常规变化。结果:换血前后患儿的呼吸、心率、血压未见显著改变,差异无统计学意义(P>0.05);换血后的TBIL、IBIL、AST较换血前显著下降(P<0.01),而K+、Ca2+、Na+、Glu、pH值换血前后则无明显改变,差异无统计学意义(P>0.05);换血后WBC、PLT较换血前显著下降,差异有统计学意义(P<0.05),PLT多在正常值范围,Hb换血前后无明显改变,差异无统计学意义(P>0.05)。结论:全自动外周动静脉同步换血疗法能安全、快速降低重症新生儿高胆红素血症患儿的胆红素水平,操作简单,值得有条件的医院推广。

Automatic synchronized blood exchange therapy of peripheral arteries and veins on treating severe neonatal hyperbilirubinemia

Objective To study the effect and safety of automatic synchronized blood exchange therapy of peripheral arteries and veins on treating severe neonatal hyperbilirubinemia.Method 52 newborns with severe neonatal hyperbilirubinemia received automatic synchronized blood exchange therapy of peripheral arteries and veins,and their vital signs,bilirubin,blood pH and the changes of blood routine examination were observed before and after transfusion.Results There was no significant difference in breathing,heart rate and blood pressure in children after blood exchange therapy（P 0.05）;The serum total bilirubin（TBIL）,indirect bilirubin（IBIL）,aspertate aminotransferase（AST） levels decreased significantly after blood exchange therapy（P 0.01）,while there was no significant difference in levels of serum kalium,calcium,sodium,glutamine and PH（P 0.05）;The levels of white blood cell count and platelets showed reductions（P 0.05） and platelets were in the range of normal value,while no obvious alterations occurred in Hb after blood exchange therapy（P 0.05）.Conclusion The automatic synchronized blood exchange therapy of peripheral arteries and veins can rapidly reduce serum bilirubin levels in neonates with severe hyperbilirubinemia.The therapy is worthy of promoting in conditional hospitals because of its convenience and security.