外周动静脉同步换血术治疗新生儿高胆红素血症35例疗效分析

目的探讨经外周动静脉同步换血术治疗新生儿高胆红素血症的临床效果。方法对35例达换血标准的新生儿高胆红素血症患儿采用外周动静脉同步换血术,比较换血前后血清胆红素、电解质、血常规、血糖的变化。结果换血后总胆红素与未结合胆红素的换出率分别为52.6%、52.0%,换血前后差异有统计学意义（P〈0.01）;换血前后血钾、血钠、血氯及血钙水平无明显变化（P〉0.05）;换血后血红蛋白水平稍下降,但差异无统计学意义（P〉0.05）;换血后白细胞和血小板水平下降,血糖水平升高,差异有统计学意义（P〈0.01）。结论外周动静脉同步换血术治疗新生儿高胆红素血症疗效显著,内环境较稳定,虽造成白细胞及血小板水平下降,血糖升高,但无临床意义,可自行恢复。

Effect analysis on the peripheral arteriovenous synchronous exchange transfusion in the treatment of 35 newborns with hyperbilirubinemia

Objective To study the clinical effect of peripheral arteriovenous synchronous exchange transfusion in the treatment of newborns with hyperbilirubinemia. Methods Thirty-five newborns with hyperbilirubinemia who reached the standard of exchange transfusion were treated with peripheral arteriovenous synchronous exchange transfusion, then the serum bilirubin, electrolytes, routine blood test and blood glucose before and after the exchange transfusion were compared. Results The exchange rate of patients＇ total bilirubin and uneonjugated bilirubin were respectively 52.6% and 52.0%, there were significant differences between the results before and after the exchange transfusion （P 〈 0.01）, while the serum potassium, sodium, serum chloride, and serum calcium before and after exchange transfusion had no significant differences （P 〉 0.05）, the hemoglobin levels after the exchange transfusion decreased slightly, hut it had no significant difference （P 〉0.05）, and leukocyte and platelets levels decreased, blood glucose level increased, there were significant differences （P 〈 0.01）. Conclusion Clinical effect of peripheral arteriovenous synchronous exchange transfu- sion in the treatment of newborns with hyperbilirubinemia is obvious, though it causes the reduction of leukocyte and platelet level and the rise of blood glucose, it has no clinical significance, and it can be self-healing.