血浆胆红素吸附时间的探讨

目的:延长血浆胆红素吸附的常规治疗时间,观察吸附效率的变化,探讨血浆胆红素吸附的最佳治疗时间。方法:11例高胆红素血症患者,使用BR350型胆红素吸附柱,每次吸附治疗时间由2 h延长至3 h,分别采取吸附前后血浆,分析胆红素吸附率的变化。结果:①治疗60min、120min、180min总胆红素水平与上机前相比均有显著差异(P<0.05)。②治疗60min、120min、180min时总胆红素吸附率分别为(51.3±6.6)%、(46.9±9.9)%、(43.5±9.2)%,直接胆红素吸附率分别为(45.9±3.3)%、(40.6±5.1)%、(39.3±6.6)%。随时间延长,吸附率呈下降趋势。③治疗期间无严重不良反应。结论:①血浆胆红素吸附对高胆红素血症疗效明确,随治疗时间延长,全血总胆红素与直接胆红素水平均可持续下降。②胆红素吸附率随治疗时间延长而降低,但在治疗180 m in时仍在40%左右,仍然有相当的吸附能力,血浆胆红素吸附的最佳治疗时间应不少于3 h。

Discussion about duration of one session in bilirubin adsorption

Objective:To find out the proper duration of one session in bilirubin adsorption by studying the change of adsorption rate in a prolonged session.Methods:BR350 adsorption column was used on 11 cases of hyperbilirubinemia during each prolonged session.Blood samples were taken just before and after adsorption column at different time points.Results: 1.Serum bilirubin level after 1h,2h,3h of adsorption was significantly different from baseline respectively.2.There was a downtrend of adsorption rate during the treatment,but the lowest rate was nearly 40%.3. No severe side effects were found during treatment.Conclusion: 1.Bilirubin adsorption is an effective treatment of hyperbilirubinemia,plasma bilirubin concentration could decrease continuously during a session.2.There is a downtrend in adsorption rate that was still above 40% even after 3 hours which meant relatively good adsorption capability.Bilirubin adsorption with BR350 should be prolonged to not less than 3 hours.