125例新生儿溶血病临床分析

目的:探讨新生儿溶血病的诊断和治疗.方法:对1996年1月～2004年3月间125例新生儿溶血病进行三项试验、胆红素、血红蛋白测定,部分行脑干听觉诱发电位检查.治疗方法有光疗、换血及输丙种球蛋白.结果:125例中ABO溶血病121例(占96.8%);三项试验中直接抗人球蛋白试验阳性49例(39.2%),释放试验阳性110例(88%),游离试验阳性87例(69.6%);高胆红素血症95例,9例发生胆红素脑病;血红蛋白＜145 g/L者68例;48例脑干听觉诱发电位异常.光疗81例,用丙球14例,换血治疗10例.结论:新生儿溶血病的诊断必须根据三项试验和临床进行综合分析;胆红素浓度高及诊治时间迟是胆红素脑病的重要危险因素,中等程度的黄疸也可导致脑损伤.对于中等程度的黄疸可行光疗或丙球治疗,重症黄疸应予丙球和(或)换血治疗.

The analysis of hemolytic disease of newborns in 125 cases

Objective To investigate the diagnosis and treatment of hemolytic di sease of newborn. Methods Three standard tests of hemolytic disease of newborn, bilirubin and hemoglobin were tested in 125 newborns with hemolytic disease. Bra instem auditory evoked potential (BAEP) was measured in a part of newborns. We t reated that patient with phototherapy,blood transfusion or/and intravenous immu ne globulin. Results 121 of the 125 patients were ABO hemolytic disease of newbo rn (96.8%). The positive rates of direct antiglobulin test (DAT),elution test and indirect antiglobulin test (IAT) were 39.2%,88%and 69.6%respectively. 95 of the 125 patients were hyperbilirubinemia of newborn,9 were bilirubin enceph olopathy,49 were disorder in BAEP. Hemoglobin of 68 patients were lower than 14 5g/L. 85 of them were treated with phototherapy,14 with immune globulin and 10 with blood transfusion. Conclusion Diagnosis of hemolytic disease of newborn mus t be based on three standard tests of hemolytic disease of newborn and clinical situation.High density of bilirubin and delay of treatment were two important ri sk factors of bilirubin encepholopathy . Medium jaundice can cause injury of bra in. Medium jaundice can be treated with phototherapy or immune globulin. Severe jaundice can be treated with immune globulin or/and blood transfusion.