• 中国科学论文统计源期刊
  • 中国科技核心期刊
  • 美国化学文摘(CA)来源期刊
  • 日本科学技术振兴机构数据库(JST)

临床输血与检验 ›› 2021, Vol. 23 ›› Issue (2): 177-180.DOI: 10.3969/j.issn.1671-2587.2021.02.009

• 临床输血 • 上一篇    下一篇

新生儿换血前后实验室指标的变化趋势*

刘倩, 王笑欢, 郭凯, 牛子健, 宋珊珊, 郭婧, 马曙轩   

  1. 100045 首都医科大学附属北京儿童医院
  • 收稿日期:2020-07-29 出版日期:2021-04-20 发布日期:2021-04-19
  • 通讯作者: 马曙轩,男,主任技师,本科,主要从事输血与免疫方面研究,(E-mail)masxfwyy@sina.com。
  • 作者简介:刘倩(1984-),女,检验师,本科,主要从事临床输血方面研究,(E-mail)lq840321@163.com。
  • 基金资助:
    *本课题受首都医科大学科研培育基金(No.PYZ19033)资助

The Change of Laboratory Indexes after Exchange Transfusions for Neonates

LIU Qian, WANG Xiao-huan, GUO Kai, et al   

  1. Department of Transfusion Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health 100045
  • Received:2020-07-29 Online:2021-04-20 Published:2021-04-19

摘要: 目的 探讨换血疗法对新生儿内环境造成的影响,为安全换血提供指导。方法 选取我院2016年1月~2018年12月诊断为ABO或Rh血型系统溶血病、并行换血治疗的高胆红素血症新生儿40例,分析换血治疗对患儿血常规、生化及凝血功能的影响。结果 40例患儿换血前总胆红素、直接胆红素和间接胆红素水平分别为390.4±17.98 μmol/L、18.41±1.038 μmol/L和370.4±18.16 μmol/L,换血后降至271.6±12.93 μmol/L、8.08±0.97 μmol/L和255.5±13.4 μmol/L(P<0.001)。换血治疗前后患儿PT和APTT的差异无统计学意义(P>0.05)。患儿换血前红细胞计数、血红蛋白及血糖值分别为(3.1±0.13)×1012/L、114.8±4.66 g/L和3.92±0.19 mmol/L,治疗后升高至(4.58±0.11)×1012/L、137.3±3.18 g/L和8.35±0.59 mmol/L,差异具有统计学意义(P<0.001)。结论 换血疗法可以有效降低患儿的血清胆红素水平,改善临床症状,但易引起部分生化、血常规及凝血指标的异常变化。术中及术后应严密监测患儿的上述指标变化,确保患儿的换血安全。

关键词: 新生儿, 高胆红素血症, 换血疗法, 血常规, 凝血功能

Abstract: Objective To explore the effect of exchange transfusions (ETs) on the internal environment of newborns, and to provide guidelines for safe procedure. Methods Fourty neonates were included with haemolytic disease of the foetus and newborn(HDFN)from January 2016 to December 2018. The change of blood routine examination, biochemistry and coagulation indicators were evaluated before and after ETs. Results After ETs, total bilirubin, direct bilirubin and indirect bilirubin decreased from 390.4±17.98 μmol/L, 18.41±1.038 μmol/L and 370.4±18.16 μmol/L to 271.6±12.93 μmol/L, 8.08±0.97 μmol/L and 255.5±13.4 μmol/L respectively(P<0.001); There was no significant difference in prothrombin time(PT)and activated partial thromboplastin time(APTT)(P>0.05); Red blood cells count, hemoglobin and blood glucose increased from(3.1±0.13)×1012/L, 114.8±4.66 g/L, 3.92±0.19 mmol/L to(4.58±0.11)×1012/L, 137.3±3.18 g/L and 8.35±0.59 mmol/L respectively(P<0.001). Conclusion ETs can significantly decline the serum bilirubin level and improve clinical symptoms, but it showed some influence on some biochemical, blood routine and coagulation indexes. During and after the procedure, we should pay attention to these indexes for the safety of ETs.

Key words: Newborn, Hyperbilirubinemia, Exchange transfusions, Blood routine examination, Coagulation function

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