外周动静脉全自动换血术治疗新生儿重度高胆红素血症的临床研究

目的探讨外周动静脉全自动换血术治疗新生儿重度高胆红素血症的疗效，以及并发症发生的危险因素。方法对37例符合换血指征的重度高胆红素血症患儿，采用全自动外周动静脉同步换血术治疗，比较换血前后血液中血清胆红素、白细胞、血红蛋白、血小板、血钾、血钙、pH值等变化情况。结果换血后总胆红素水平明显下降，差异有统计学意义（P〈0．01）；血红蛋白及血糖较换血前升高，差异有统计学意义（p〈0．05）；白细胞、血小板及血钙较换血前降低（P〈0．01）。胎龄≤32周、体重〈1500g、换血时患儿患病为并发症发生的危险因素（P〈0．05）。结论全自动动静脉换血疗法是治疗高胆红素血症的最迅速有效方法，操作简便、安全性高，值得临床推广应用。

Treatment of Neonates with Severe Hyperbilirubinemia by Automated Peripheral Arteriovenous Exchange Transfusion

Objective To investigate the effect of automated peripheral arteriovenous exchange transfusion for treatment of severe hyperbilirubinemia in neonates, and the potential risk factors of complications. Methods 37 neonates with severe hyperbilirubinemia underwent automated peripheral arteriovenous exchange transfusion. The changes in the blood gasses, electrolytes and some biochemical indices after and before the treatment were compared, such as serum bilirubin, white blood cells, platelets, hemoglobin, kalium, calcium, pH, et al. Results After the exchange transfusion, the level of the total serum bilirubin decreased significantly（P〈0.01）. The hemoglobin and the blood glucose increased significantly（P〈0.01）. The white blood cells, platelets, and calcium decreased significantly（P〈0.01）. The risk factors of complications were fetus less than 32 weeks, the birth weight less than 1 500 g, and the neonates sick during the exchange transfusion. Conclusion The treatment of neonatal hyperbilirubinemia by peripheral arteriovenous automatic synchronous exchange transfusion is reliable, effective, and easy to operate, which was worthy widely promoted in the clinical application.