中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2009年
12期
1322-1324
,共3页
高胆红素血症%新生儿%换血术%内环境
高膽紅素血癥%新生兒%換血術%內環境
고담홍소혈증%신생인%환혈술%내배경
Hyperbilirubinemia%Neonatal%Blood exchange%Internal environment
目的 探讨应用换血术治疗新生儿高胆红素血症对血液内环境各项指标可能造成的变化.方法 对35例确诊为高胆红素血症新生儿采用外周动静脉同步换血术.使用同型全血,平均换血量为(136.9±27.4)ml/kg.换血速度为92 ml/(kg·h),换血前后监测胆红素、电解质、血常规、血糖.结果 换血后总胆红素换出率为53.78%,换血前后血Na~+、Cl~-、血糖差异无统计学意义(P均＞0.05),K~+明显降低[换血前为(4.45±2.40)mmol/L,换血后为(3.87±0.52)mmol/L,t=21.979,P＜0.05].换血后总胆红素、Hb、PLT、WBC、血清游离钙下降[换血前总胆红素、Hb、PLT、WBC、血清游离钙分别为(511.52±80.21)μmol/L、(145.20±11.70)g/L、(207.84±70.67)×10~9/L、(16.90±10.56)×10~9/L、(1.26±0.32)mmol/L,换血后分别为(236.41±66.54)μmol/L、(128.66±2.54)g/L、(134.86±48.61)×10~9/L、(8.94±7.44)×10~9/L、(0.99±0.22)mmol/L,P＜0.05或P＜0.01].结论 换血对高胆红素血症新生儿血Na~+、Cl~-和血糖无明显影响;对总胆红素、Ca~(2+)、Hb、K~+、PLT、WBC影响较大.
目的 探討應用換血術治療新生兒高膽紅素血癥對血液內環境各項指標可能造成的變化.方法 對35例確診為高膽紅素血癥新生兒採用外週動靜脈同步換血術.使用同型全血,平均換血量為(136.9±27.4)ml/kg.換血速度為92 ml/(kg·h),換血前後鑑測膽紅素、電解質、血常規、血糖.結果 換血後總膽紅素換齣率為53.78%,換血前後血Na~+、Cl~-、血糖差異無統計學意義(P均＞0.05),K~+明顯降低[換血前為(4.45±2.40)mmol/L,換血後為(3.87±0.52)mmol/L,t=21.979,P＜0.05].換血後總膽紅素、Hb、PLT、WBC、血清遊離鈣下降[換血前總膽紅素、Hb、PLT、WBC、血清遊離鈣分彆為(511.52±80.21)μmol/L、(145.20±11.70)g/L、(207.84±70.67)×10~9/L、(16.90±10.56)×10~9/L、(1.26±0.32)mmol/L,換血後分彆為(236.41±66.54)μmol/L、(128.66±2.54)g/L、(134.86±48.61)×10~9/L、(8.94±7.44)×10~9/L、(0.99±0.22)mmol/L,P＜0.05或P＜0.01].結論 換血對高膽紅素血癥新生兒血Na~+、Cl~-和血糖無明顯影響;對總膽紅素、Ca~(2+)、Hb、K~+、PLT、WBC影響較大.
목적 탐토응용환혈술치료신생인고담홍소혈증대혈액내배경각항지표가능조성적변화.방법 대35례학진위고담홍소혈증신생인채용외주동정맥동보환혈술.사용동형전혈,평균환혈량위(136.9±27.4)ml/kg.환혈속도위92 ml/(kg·h),환혈전후감측담홍소、전해질、혈상규、혈당.결과 환혈후총담홍소환출솔위53.78%,환혈전후혈Na~+、Cl~-、혈당차이무통계학의의(P균＞0.05),K~+명현강저[환혈전위(4.45±2.40)mmol/L,환혈후위(3.87±0.52)mmol/L,t=21.979,P＜0.05].환혈후총담홍소、Hb、PLT、WBC、혈청유리개하강[환혈전총담홍소、Hb、PLT、WBC、혈청유리개분별위(511.52±80.21)μmol/L、(145.20±11.70)g/L、(207.84±70.67)×10~9/L、(16.90±10.56)×10~9/L、(1.26±0.32)mmol/L,환혈후분별위(236.41±66.54)μmol/L、(128.66±2.54)g/L、(134.86±48.61)×10~9/L、(8.94±7.44)×10~9/L、(0.99±0.22)mmol/L,P＜0.05혹P＜0.01].결론 환혈대고담홍소혈증신생인혈Na~+、Cl~-화혈당무명현영향;대총담홍소、Ca~(2+)、Hb、K~+、PLT、WBC영향교대.
Objective To discuss the influence of blood exchange transfusions on hemato- microenvironment of neonates with hyperbilirubinemian.Methods Blood exchange transfusion was performed in 35 neonates.Mean transfusion volume was (136.9±27.4) ml/kg.The speed of blood exchange transfusion was 92 ml/(kg·h).Blood bilirubin,blood electrolyte,blood routine and blood sugar levels were measured before,during and after the transfusion.Results Serum total bilirubin (TB) decreased by 53.78% after blood exchange,but there was no change in Na~+,Cl~-,and blood sugar (P＞0.05),and K~+ was remarkably decreased from (4.45±2.40)mmol/L to (3.87±0.52)mmol/L (t=21.979,P＜0.05).TB,Hb,PLT,WBC,Ca~(2+) were decreased[TB from(511.52±80.21) μmol/L to (236.41±66.54) μmol/L;Hb from (145.20±11.70) g/L to (128.66±2.54) g/L;PLT from (207.84±70.67)×10~9/L to (134.86±48.61)×10~9/L;WBC from (16.90±10.56)×10~9/L to (8.94±7.44)×10~9/L,and Ca~(2+) from (1.26±0.32) mmol/L to (0.99±0.22) mmol/L,P＜0.05 or ＜0.01].Conclusions Blood exchange transfusion can not influence Na~+,Cl~-,and blood sugar,but has remarkable effect on total bilirubin,Ca~(2+),Hb,K~+,PLT,and WBC.
