外周动静脉成分血同步换血治疗新生儿高胆红素血症25例临床分析

目的探讨应用成分血进行外周动静脉同步换血在新生儿高未结合胆红素血症中的临床效果。方法采用成分血进行外周动静脉同步换血治疗25例新生儿高未结合胆红素血症，术前和术后进行血清胆红素、血红蛋白、血小板、白细胞等的监测。结果换血术后血清总胆红素下降50．25％（P〈0．01），未结合胆红素下降51．21％（P〈0．01），结合胆红素下降34．82％（P〈0．01），换出的主要是未结合胆红素，最高下降63．25％；换血后血红蛋白变化不大（P〉0．05），白细胞下降（P〈0．01），血小板下降（P〈0．01）。结论采用成分血进行外周动静脉同步换血治疗新生儿高胆红素血症效果满意，操作简便易学，值得广泛推广，尤其在基层二级医院推行。

Clinical analysis of synchronous exchange transfusion of peripheral arterial and venous blood components in treatment of 25 patients with neonatal hyperbilirubinemia

Objective To investigate the clinical curative effects of synchronous exchange transfusion of peripheral arterial and venous blood components in the treatment of neonatal hyperbilirubinemia.Methods The synchronous exchange transfusion of peripheral arterial and venous blood components was used to treat 25 patients with neonatal hyperbilirubinemia.The preoperative and postoperative serum bilirubin,hemoglobin,platelets,white blood cells and other indicators were monitored.Results After the blood exchange transfusion,the total serum bilirubin decreased by 50.25%(P < 0.01),the unconjugated bilirubin decreased by 51.21%(P < 0.01) and the conjugated bilirubin decreased by 34.82%(P < 0.01).The unconjugated bilirubin was the major exchange,with the maximum decline of 63.25%.After the blood exchange transfusion,the hemoglobin did not change significantly(P > 0.05),the white blood cell declined(P < 0.01) and the platelets declined(P < 0.01).Conclusion The application of synchronous exchange transfusion of peripheral arterial and venous blood components in the treatment of neonatal hyperbilirubinemia is easily operative and worthy of wide promotion especially in primary secondary hospitals.