中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2015年
7期
43-44
,共2页
换血疗法%贫血%新生儿%高胆红素血症
換血療法%貧血%新生兒%高膽紅素血癥
환혈요법%빈혈%신생인%고담홍소혈증
Exchange transfusion%Anemia%Neonate%Hyperbilirubinemia
目的 分析不同输血干预对预防换血后贫血的疗效及对血液内环境的影响.方法 将2011年5月至2012年4月郑州大学第三附属医院64例换血治疗患儿随机分为研究组和对照组,均采用O型红细胞和AB型血浆(1U∶ 100 ml)的重组血,换血后分别给予不同量重组血输入(研究组20 ml/kg±速尿1 mg/kg,对照组15m l/ks),比较两组换血前后血清总胆红素置换率、红细胞(RBC)、血红蛋白(Hb)、红细胞比容(Hct)、血压、电解质及住院天数等指标的变化.结果 研究组与对照组胆红素置换率比较差异未见统计学意义(P=0.07).相对于对照组,研究组换血后红细胞、血红蛋白、红细胞压积升高,与换血前比较差异有统计学意义(P＜0.01),血压、血气、电解质变化差异未见统计学意义(P分别为0.55,0.71,0.19),住院时间明显缩短(P=0.03).结论 输血干预(20ml/kg)可显著预防单倍量重组血换血治疗后贫血的发生,对血液内环境无明显影响,且能明显缩短住院时间.
目的 分析不同輸血榦預對預防換血後貧血的療效及對血液內環境的影響.方法 將2011年5月至2012年4月鄭州大學第三附屬醫院64例換血治療患兒隨機分為研究組和對照組,均採用O型紅細胞和AB型血漿(1U∶ 100 ml)的重組血,換血後分彆給予不同量重組血輸入(研究組20 ml/kg±速尿1 mg/kg,對照組15m l/ks),比較兩組換血前後血清總膽紅素置換率、紅細胞(RBC)、血紅蛋白(Hb)、紅細胞比容(Hct)、血壓、電解質及住院天數等指標的變化.結果 研究組與對照組膽紅素置換率比較差異未見統計學意義(P=0.07).相對于對照組,研究組換血後紅細胞、血紅蛋白、紅細胞壓積升高,與換血前比較差異有統計學意義(P＜0.01),血壓、血氣、電解質變化差異未見統計學意義(P分彆為0.55,0.71,0.19),住院時間明顯縮短(P=0.03).結論 輸血榦預(20ml/kg)可顯著預防單倍量重組血換血治療後貧血的髮生,對血液內環境無明顯影響,且能明顯縮短住院時間.
목적 분석불동수혈간예대예방환혈후빈혈적료효급대혈액내배경적영향.방법 장2011년5월지2012년4월정주대학제삼부속의원64례환혈치료환인수궤분위연구조화대조조,균채용O형홍세포화AB형혈장(1U∶ 100 ml)적중조혈,환혈후분별급여불동량중조혈수입(연구조20 ml/kg±속뇨1 mg/kg,대조조15m l/ks),비교량조환혈전후혈청총담홍소치환솔、홍세포(RBC)、혈홍단백(Hb)、홍세포비용(Hct)、혈압、전해질급주원천수등지표적변화.결과 연구조여대조조담홍소치환솔비교차이미견통계학의의(P=0.07).상대우대조조,연구조환혈후홍세포、혈홍단백、홍세포압적승고,여환혈전비교차이유통계학의의(P＜0.01),혈압、혈기、전해질변화차이미견통계학의의(P분별위0.55,0.71,0.19),주원시간명현축단(P=0.03).결론 수혈간예(20ml/kg)가현저예방단배량중조혈환혈치료후빈혈적발생,대혈액내배경무명현영향,차능명현축단주원시간.
Objective To analyze the effect of additional transfusion on preventing anemia after exchange transfusion.Methods From May 2011 to April 2012 in the third affiliated hospital of Zhengzhou university;sixty-four newborn infants with hyperbilirubinemia,treated by exchange transfusion with mixed blood(AB type plasma 1U was mixed with O type red blood cell 100 ml),were randomly divided into two groups.Both of the two groups received the double exchange transfusion in accordance with 150-180 ml/kg.After exchange,33 patients in treatment group,received mixed blood transfusion with 20 ml/kg(total volume was 60 ml);31 patients in control group,received additional transfusion with 15 ml/kg(total volume was 45 ml).The indicators,which included the exchange rate of neonatal serum bilirubin,RBC,hemoglobin (Hb),hematocrit (Hct),blood pressure,the elctrocyte and gas analysis,were monitored before and after the exchange transfusion.Results The exchange rates of serum bilirubin of treatment group and control group were (43.26 ± 11.9) ％ and (50.19 ± 12.6) ％,respectively,there was no significant difference between the two groups(P =0.07).Contrast to the control group,the difference of RBC,hemoglobin and hematocrit between before and after exchange transfusion showed significant difference in the treatment group(P ＜ 0.05).The difference of electrolyte (such as K +,Ca2 +) and blood gas value between before and after the exchange transfusion were not significantly different (P ＞ 0.05).There was significant difference in hospitalization days [(8 ± 2) d vs (9 ± 3) d] between the two groups (P =0.03).Conclusions Additional transfusion (25 ml/kg) can significantly prevent anemia after the exchange transfusion.It has no impact on blood circulation in neonates and can sho.rten the hospital days.
