CAJ | 학술논문

目的：分析新生儿高胆红素血症行换血治疗的效果以及治疗后的不良反应。方法回顾性分析262例采用换血治疗的高胆红素血症新生儿的临床资料，比较治疗前后血电解质、血生化、血气分析以及血常规结果，并观察治疗后不良反应发生情况。结果患者治疗前后的血钾、剩余碱(BE)值、 pH值、血小板、血红蛋白、间接胆红素、血清总胆红素等指标相比差异明显，有统计学意义(P＜0.05)；患者治疗前后的直接胆红素、白细胞、血钠、血氯以及血钙等指标相比差异不显著，无统计学意义(P＞0.05)。患者治疗后的不良反应主要有代谢性酸中毒、低钾血症以及血小板减少，通过对其进行适当处理后均恢复正常。结论在对高胆红素血症新生儿进行临床治疗时，换血治疗可以有效改善患者的相关临床症状，不过在治疗过程中一定要对患者的换血适应症以及相关指征进行严格控制，并对患者在治疗后的不良反应进行积极处理。
목적：분석신생인고담홍소혈증행환혈치료적효과이급치료후적불량반응。방법회고성분석262례채용환혈치료적고담홍소혈증신생인적림상자료，비교치료전후혈전해질、혈생화、혈기분석이급혈상규결과，병관찰치료후불량반응발생정황。결과환자치료전후적혈갑、잉여감(BE)치、 pH치、혈소판、혈홍단백、간접담홍소、혈청총담홍소등지표상비차이명현，유통계학의의(P＜0.05)；환자치료전후적직접담홍소、백세포、혈납、혈록이급혈개등지표상비차이불현저，무통계학의의(P＞0.05)。환자치료후적불량반응주요유대사성산중독、저갑혈증이급혈소판감소，통과대기진행괄당처리후균회복정상。결론재대고담홍소혈증신생인진행림상치료시，환혈치료가이유효개선환자적상관림상증상，불과재치료과정중일정요대환자적환혈괄응증이급상관지정진행엄격공제，병대환자재치료후적불량반응진행적겁처리。
Objective To study the effects and adverse reactions of exchange transfusion in treating neonatal hyperbilirubinemia. Methods Clinical data of 262 newborns with hyperbilirubinemia received exchange transfusion were retrospectively analyzed. The results of blood electrolytes, blood biochemical test, blood gas analysis and blood routine examination before and after the treatment were compared, and the incidence of adverse reactions was observed. Results The blood potassium, base excess value, pH value, blood platelet, hemoglobin, indirect bilirubin, serum total bilirubin before and after treatment had statistical difference (P<0.05), the direct bilirubin, leukocyte, serum sodium, serum chloride, serum calcium before and after treatment had no statistical difference (P >0.05). The main adverse reactions of patients were metabolic acidosis, hypokalemia and thrombocytopenia, all patients returned to normal after giving proper treatment. Conclusions In clinical treatment of neonatal hyperbilirubinemia, exchange transfusion can effectively improve the patient's clinical symptoms, but the relevant indications must be strictly controlled, and the adverse reactions should be given positive treatment.