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目的探讨新生儿高胆红素血症双倍换血治疗前后血液内环境的变化。方法对20名新生儿高胆红素血症患儿采用经外周动静脉同步换血术,ABO溶血病者采用O型去白红细胞和AB型血浆,非溶血病者采用同型血,按(70±5)ml血浆与2U去白红细胞混合,以(150—180)ml/kg双倍量换血,监测换血前后新生儿血清总胆红素、血常规、电解质及血糖等指标的变化。结果换血前后患儿血清胆红素分别为(448.1±92.772)μmol/L与(258.78±103.347)μmol/L,二组比较有显著性差异(P<0.05),换血后血钾、血氯降低,血钠无明显变化,血钙升高;血糖暂时性升高,但在24 h内自行恢复至正常。可有白细胞及血小板明显下降(P<0.05)。结论换血后可出现低钾、低氯、低钙、高血糖、低白细胞和血小板血症的发生,应预防感染、出血和电解质紊乱的发生。
Objective To investigate the change of blood environment before and after treatment of double transfusion in neonatal hyperbilirubinemia. Methods 20 neonates with hyperbilirubinaemia were treated by synchronized peripheral arterial and venous transplants, while patients with ABO hemolytic disease were treated with O-demethylating erythrocytes and AB-type plasma. Patients without hemolytic disease were treated with the same type of blood, 5) ml of plasma was mixed with 2U of de-erythroblasts to change the amount of serum total bilirubin, blood, electrolytes and blood glucose before and after transfusion with (150-180) ml / kg double exchange. Results The levels of serum bilirubin were 448.1 ± 92.772 μmol / L and 258.78 ± 103.347 μmol / L before and after transfusions, respectively. There were significant differences between the two groups (P <0.05) , No significant change in serum sodium, elevated serum calcium; blood glucose increased temporarily, but returned to normal within 24 h. There may be a significant decline in white blood cells and platelets (P <0.05). Conclusion After the blood transfusion, hypokalemia, hypochlorosis, hypocalcemia, hyperglycemia, hypoalbuminaemia and thrombocytopenia may occur, infection, hemorrhage and electrolyte imbalance should be prevented.