外周动静脉交换联合静脉注射丙种球蛋白治疗新生儿溶血的疗效观察

中国综合临床 Pub Date : 2019-11-01 DOI:10.3760/CMA.J.ISSN.1008-6315.2019.06.017

Zhiguang Chen

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RBC in children in two groups after treatment was(4.3±0.8)×1012/L, (4.2±1.0)×1012/L vs.before(5.2±1.1)×1012/L, (6.4±1.3)×1012/L, Hb after treatment in both groups was (125.8±11.2) g/L, (124.9±10.5) g/L vs.before (148.9±26.5) g/L, (159.3±14.6) g/L and reticulocyte count after treatment in both groups were (7.6±2.1)%, (7.3±1.8)% vs.(5.2±1.3)%, (3.1±0.5)% were significantly improved, but the peripheral arteriovenous exchange+ gamma globulin group was significantly better than the peripheral arteriovenous transfusion group, the difference was statistically significant (all P<0.05). The hospitalization time (10.3±1.9) d and jaundice regression time (8.6±0.5) d in the peripheral arteriovenous exchange + gamma globulin group were significantly lower than those in the peripheral arteriovenous exchange group ((15.5±2.6) d, (10.0±1.1) d). The difference was statistically significant(t=9.553, 6.855, P<0.05). 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引用次数: 0

摘要

目的观察外周动静脉交换联合静脉注射丙种球蛋白治疗新生儿溶血的疗效。方法选取2013年1月至2018年5月中国医科大学第一附属医院收治的70例符合外周动静脉交换指征的新生儿溶血患儿作为研究对象。采用随机数字表法将患者分为外周动静脉交换组和“外周动静脉交换+ γ球蛋白”组，每组35例。观察两组患者基线资料、治疗前后血清胆红素变化、部分血液生化指标、住院时间及黄疸消退时间。结果治疗后12、24、48、72 h外周动静脉交换+ γ球蛋白组血清胆红素水平(241.5±48.1)、(184.6±26.3)、(166.3±18.5)、(133.5±20.8)μmol/L显著低于外周动静脉交换组(299.3±32.5)、(225.7±38.9)、(195.4±21.1)、(173.8±35.4)μmol/L，差异有统计学意义(P<0.05)。两组患儿治疗后RBC分别为(4.3±0.8)×1012/L、(4.2±1.0)×1012/L，治疗前分别为(5.2±1.1)×1012/L、(6.4±1.3)×1012/L，两组治疗后Hb分别为(125.8±11.2)g/L、(124.9±10.5)g/L，治疗前分别为(148.9±26.5)g/L、(159.3±14.6)g/L，两组治疗后网织红细胞计数分别为(7.6±2.1)%、(7.3±1.8)%、(5.2±1.3)%、(3.1±0.5)%均有显著改善。外周动静脉交换+丙种球蛋白组明显优于外周动静脉输液组，差异有统计学意义(均P<0.05)。外周动静脉交换+丙种球蛋白组住院时间(10.3±1.9)d、黄疸消退时间(8.6±0.5)d显著低于外周动静脉交换组(15.5±2.6)d、(10.0±1.1)d，差异有统计学意义(t=9.553、6.855,P<0.05)。外周动静脉交换+丙种球蛋白组患儿治疗后再溶血发生率显著低于外周动静脉交换组(5.7%(2/35)vs.25.7%(9/35))，差异有统计学意义(χ2=5.285, P=0.022)。结论外周动静脉交换联合静脉注射丙种球蛋白是治疗新生儿溶血的有效方法。可显著降低血清胆红素，改善血液生化指标，缩短住院时间和黄疸消退时间，安全可靠。关键词:新生儿溶血;外周动静脉交换;丙种球蛋白;治疗效果

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Therapeutic effect of peripheral arteriovenous exchange combined with intravenous gamma globulin on neonatal hemolysis

Objective To observe the effect of peripheral arteriovenous exchange combined with intravenous gamma globulin in the treatment of neonatal hemolysis. Methods Seventy children with neonatal hemolysis admitted to the first affiliated Hospital of China Medical University from January 2013 to May 2018 and who met the indications for peripheral arteriovenous exchange were selected as the study subjects.The patients were divided into peripheral arteriovenous exchange group and " peripheral arteriovenous exchange+ gamma globulin" group by random number table method, with 35 cases in each group.Baseline data of the two groups, changes of serum bilirubin before and after treatment, partial blood biochemical indicators, hospitalization time and jaundice regression time were observed. Results The levels of serum bilirubin ((241.5±48.1), (184.6±26.3), (166.3±18.5), (133.5±20.8) μmol/L) in peripheral arteriovenous exchange + gamma globulin group were significantly lower than those in peripheral arteriovenous exchange group ((299.3±32.5), (225.7±38.9), (195.4±21.1), (173.8±35.4) μmol/L) at 12, 24, 48 and 72 hours after treatment, the difference was significant (P<0.05). RBC in children in two groups after treatment was(4.3±0.8)×1012/L, (4.2±1.0)×1012/L vs.before(5.2±1.1)×1012/L, (6.4±1.3)×1012/L, Hb after treatment in both groups was (125.8±11.2) g/L, (124.9±10.5) g/L vs.before (148.9±26.5) g/L, (159.3±14.6) g/L and reticulocyte count after treatment in both groups were (7.6±2.1)%, (7.3±1.8)% vs.(5.2±1.3)%, (3.1±0.5)% were significantly improved, but the peripheral arteriovenous exchange+ gamma globulin group was significantly better than the peripheral arteriovenous transfusion group, the difference was statistically significant (all P<0.05). The hospitalization time (10.3±1.9) d and jaundice regression time (8.6±0.5) d in the peripheral arteriovenous exchange + gamma globulin group were significantly lower than those in the peripheral arteriovenous exchange group ((15.5±2.6) d, (10.0±1.1) d). The difference was statistically significant(t=9.553, 6.855, P<0.05). The children who had re-hemolytic after treatment in the peripheral arteriovenous exchange + gamma globulin group were significantly lower than the peripheral arteriovenous exchange group (5.7%(2/35) vs.25.7%(9/35)), the difference was statistically significant (χ2=5.285, P=0.022). Conclusion Peripheral arteriovenous exchange combined with intravenous gamma globulin is effective in the treatment of neonatal hemolysis.It can significantly reduce serum bilirubin, improve blood biochemical parameters, shorten hospitalization time and jaundice regression time, and is safe and reliable. Key words: Neonatal hemolysis; Peripheral arteriovenous exchange; Gamma globulin; Therapeutic effect

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来源期刊

中国综合临床

CiteScore

0.10

自引率

0.00%

发文量

16855

期刊介绍： Clinical Medicine of China is an academic journal organized by the Chinese Medical Association (CMA), which mainly publishes original research papers, reviews and commentaries in the field. Clinical Medicine of China is a source journal of Peking University (2000 and 2004 editions), a core journal of Chinese science and technology, an academic journal of RCCSE China Core (Extended Edition), and has been published in Chemical Abstracts of the United States (CA), Abstracts Journal of Russia (AJ), Chinese Core Journals (Selection) Database, Chinese Science and Technology Materials Directory, Wanfang Database, China Academic Journal Database, JST Japan Science and Technology Agency Database (Japanese) (2018) and other databases.