重庆医学2017，Vol.46Issue(19)：2618-2620,2623,4.DOI:10.3969/j.issn.1671-8348.2017.19.008
单双倍血量换血治疗新生儿高胆红素血症的效果研究
Study on the efficacy of exchange transfusion for neonatal hyperbilirubinemia with single or double volume
摘要
Abstract
Objective To compare the clinical efficacy between single and double volume exchange transfusion for neonatal hyperbilirubinemia,and to verify whether single volume exchange transfusion had advantages in maintaining homeostasis and reducing blood transfusion related complications.Methods Clinical materials of 86 neonates with neonatal hyperbilirubinemia who received blood exchange transfusion,from December 2013 to December 2014,in the diagnosis and treatment center of our hospital were retrospectively analyzed.Cases were divided into the single volume group (35 cases,with a blood volume 80-110 mL/kg) and double volume group (51 cases,with a blood volume 150-180 mL/kg) based on blood volume per kilogram of body weight.Comparisons of the homeostasis changes between pre-transfusion and post-transfusion were performed for each group,and the incidence rate of major adverse events were compared between the two groups.Results (1)In the single volume group and double volume group,the average blood exchange transfusion volumes were (98.16 ± 10.75) mL/kg and (157.78 ± 7.37) mL/kg,the exchange rate of bilirubin were (41.68± 8.52) ％ and (50.22 ± 13.14) ％,and the average time for blood transfusion were (85.60 ±18.66) min and(1 1B.22± 24.81)min respectively,and there were statistically significant differences in the exchange rate of bilirubin and average time for blood transfusion between the two groups (P＜0.05).(2)Compared with pre-transfusion,WBC and platelet (PLT)count,levels of serum total bilirubin (TBIL),albumin,serum potassium,serum sodium,serum chlorine,serum calcium and HCO3-,and pH value were significantly decreased after blood exchange transfusion,while RBC count,PT,APTT and blood glucose were significantly increased in the two groups (P＜0.01).Moreover,the changes of blood glucose,PLT and TBIL in the double volume group were more significantly than those in the single volume group,there were statistically significant differences (P＜0.05).No statistically significant difference was found in the rate of major adverse events between the two groups (P＞0.05).Conclusion Compared with double blood exchange transfusion therapy,single volume exchange transfusion can significantly decrease plasmic bilirubin level with less change of homeostasis,less blood volume for transfusion and less human resources consumption,its value in clinical application is recognized.关键词
高胆红素血症,新生儿/单倍量换血/临床效果Key words
hyperbilirubinemia, neonatal/single volume exchange transfusion/clinical efficacy分类
医药卫生引用本文复制引用
杨丽莎,郑显兰,何华云,陈新红,敖沙,李卓能..单双倍血量换血治疗新生儿高胆红素血症的效果研究[J].重庆医学,2017,46(19):2618-2620,2623,4.基金项目
国家临床重点专科建设项目(国卫办医涵[2013]544号) （国卫办医涵[2013]544号）
重庆市卫计委医学科研项目(20142041). （20142041）
