新生儿高胆红素血症换血治疗的临床结果分析(1)
[摘要] 目的 分析换血治疗新生儿重度高胆红素血症的临床效果和临床相关资料，为临床的治疗提供相关依据。方法 方便选择2011年1月—2016年12月福建省妇幼保健院新生儿科125例因重度高胆红素血症而收治入院进行高胆红素血症相关治疗且均有换血治疗处理的患儿作为分析案例，对换血前后血清总胆红素、直接胆红素、间接胆红素、血红蛋白的变化进行比较分析并回顾性分析患儿的临床相关资料，探讨影响换血治疗效果的相关因素。 结果 患儿经过换血治疗后血清总胆红素、直接胆红素和间接胆红素平均分别下降(219.682±82.896)、(14.318±14.559)μmol/L和(203.673±81.372)μmol/L；血红蛋白上升(30.12±36.867)g/L；AST、γ-GT平均分别下降(28.85±41.958)、(91.97±68.749)U/L，差异有统计学意义(P<0.001)；ALT差异无统计学意义(P>0.05)。 结论 换血治疗是临床上治疗新生儿重度高胆红素血症最及时、有效的方法。
[关键词] 高胆红素血症；换血治疗；新生儿
[中图分类号] R72 [文献标识码] A [文章编号] 1674-0742(2017)06(b)-0040-03
[Abstract] Objective To analyze the clinical effect and clinical related data of blood change treatment of herbae artemisiae capillariae decoction in newborns and provide the related data for the clinical treatment. Methods Convenient selection 125 cases of children with herbae artemisiae capillariae decoction for related treatment such as blood change treatment admitted and treated in our hospital from January 2011 to December 2016 were selected and the changes of serum total bilirubin， direction and indirect bilirubin and hemoglobin before and after blood change were compared and the clinical related data of children were retrospectively analyzed and the related influence factors of blood change treatment effect was discussed. Results After the blood change treatment， the average decrease levels of serum total bilirubin， direction and indirect bilirubin were respectively (219.682±82.896)，(14.318±14.559)，(203.673±81.372)μmol/L， and the increase level of hemoglobin was (30.12±36.867)g/L， and the average decrease levels of AST and γ-GT were respectively (28.85±41.958)，(91.97±68.749)U/L， and the differences were statistically significant(P<0.001)， and the difference in the ALT was not statistically significant(P>0.05). Conclusion The blood change treatment is the most timely and effective method in clinical treatment of herbae artemisiae capillariae decoction in newborns.
[Key words] Herbae artemisiae capillariae decoction； Blood change treatment； Newborns
新生兒重度高胆红素血症的病理生理主要是由于患儿体内的红细胞过度裂解，产生大量的间接胆红素，造成机体各组织系统功能受到损害。换血疗法是目前临床治疗高胆红素血症最迅速有效的方法，目的是换出体内血液中的大量胆红素、游离抗体、致敏红细胞等。胆红素过高越过血脑屏障会损伤神经系统，病情严重者甚至会致死或者致残[1-2]。现将福建省妇幼保健院2011年1月—2016年12月收治的125例重度高胆红素血症患儿各项数据分析结果，现报道如下。
1 资料与方法
1.1 一般资料
方便收集福建省妇幼保健院新生儿科125例因重度高胆红素血症而收治入院均有换血治疗处理的患儿的临床资料。125例高胆红素血症患儿均符合换血标准[3]，其中男77例，女48例；足月儿108例，早产儿17例；；新生儿溶血3项检测阴性59例、阳性66例；换血时间从1～12 d不等。
1.2 检测仪器
胆红素的检测仪器为“雅培al16200”；血红蛋白的检测仪器为“sysmex XN-3000”；血型、新生儿溶血的检测仪器为“WADiana DG-57”。, http://www.100md.com(吴坤海 陈陆飞 黄慧芳 蔡文红 林惠姿)
[关键词] 高胆红素血症；换血治疗；新生儿
[中图分类号] R72 [文献标识码] A [文章编号] 1674-0742(2017)06(b)-0040-03
[Abstract] Objective To analyze the clinical effect and clinical related data of blood change treatment of herbae artemisiae capillariae decoction in newborns and provide the related data for the clinical treatment. Methods Convenient selection 125 cases of children with herbae artemisiae capillariae decoction for related treatment such as blood change treatment admitted and treated in our hospital from January 2011 to December 2016 were selected and the changes of serum total bilirubin， direction and indirect bilirubin and hemoglobin before and after blood change were compared and the clinical related data of children were retrospectively analyzed and the related influence factors of blood change treatment effect was discussed. Results After the blood change treatment， the average decrease levels of serum total bilirubin， direction and indirect bilirubin were respectively (219.682±82.896)，(14.318±14.559)，(203.673±81.372)μmol/L， and the increase level of hemoglobin was (30.12±36.867)g/L， and the average decrease levels of AST and γ-GT were respectively (28.85±41.958)，(91.97±68.749)U/L， and the differences were statistically significant(P<0.001)， and the difference in the ALT was not statistically significant(P>0.05). Conclusion The blood change treatment is the most timely and effective method in clinical treatment of herbae artemisiae capillariae decoction in newborns.
[Key words] Herbae artemisiae capillariae decoction； Blood change treatment； Newborns
新生兒重度高胆红素血症的病理生理主要是由于患儿体内的红细胞过度裂解，产生大量的间接胆红素，造成机体各组织系统功能受到损害。换血疗法是目前临床治疗高胆红素血症最迅速有效的方法，目的是换出体内血液中的大量胆红素、游离抗体、致敏红细胞等。胆红素过高越过血脑屏障会损伤神经系统，病情严重者甚至会致死或者致残[1-2]。现将福建省妇幼保健院2011年1月—2016年12月收治的125例重度高胆红素血症患儿各项数据分析结果，现报道如下。
1 资料与方法
1.1 一般资料
方便收集福建省妇幼保健院新生儿科125例因重度高胆红素血症而收治入院均有换血治疗处理的患儿的临床资料。125例高胆红素血症患儿均符合换血标准[3]，其中男77例，女48例；足月儿108例，早产儿17例；；新生儿溶血3项检测阴性59例、阳性66例；换血时间从1～12 d不等。
1.2 检测仪器
胆红素的检测仪器为“雅培al16200”；血红蛋白的检测仪器为“sysmex XN-3000”；血型、新生儿溶血的检测仪器为“WADiana DG-57”。, http://www.100md.com(吴坤海 陈陆飞 黄慧芳 蔡文红 林惠姿)