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目的探讨非抗-D致新生儿Rh溶血病(Rh HDN)的实验室诊断和输血治疗的血液选择。方法对6名非抗-D Rh HDN患儿采取相应检测和治疗:1)Rh HDN血清学检测,包括直接抗球蛋白试验、红细胞抗体放散试验、血清游离抗体试验、Rh血型、ABO血型、IgG抗体及抗体效价鉴定;2)对其中2名严重贫血患儿做输血治疗,对其中3名严重黄疸患儿给予换血治疗。结果 6例病例中确诊为RhE HDN 4例,Rhe HDN 1例,Rhc HDN 1例。1名未选择Rh血型与母亲相同的血液换血治疗的患儿连续2次换血,其余4名需用血的重症患儿在实验室明确诊断的基础上,选择用Rh血型与母亲相同,ABO血型与患儿相同的血液输注,2名患儿各换血1次(RBC 800ml/次),2名患儿7次输血(RBC 40ml×4和80ml×3)均取得良好疗效。结论完备的Rh HDN确诊检测能避免发生因Rh血型不合引起的新生儿输血后溶血,减少换血次数,降低Rh DHN的死亡率和致残率。
Objective To investigate the laboratory diagnosis and blood transfusion of non-anti-D Rh Rh hemolytic disease (Rh HDN). Methods Six patients with non-anti-D Rh HDN were detected and treated as follows: 1) Rh HDN serological tests, including direct antiglobulin test, erythrocyte antibody excretion test, serum free antibody test, Rh blood group, ABO blood group, Antibody and antibody titer were identified. 2) Blood transfusions were performed on 2 of the 2 children with severe anemia, and 3 of them were given transfusion therapy for severe jaundice. Results Among the 6 cases, 4 cases were diagnosed as RhE HDN, 1 case was Rhe HDN and 1 case was Rhc HDN. A non-selected Rh blood group with the same mother’s blood transfusions in children with transfusion 2 consecutive times, the remaining 4 need to use blood in children with a clear diagnosis of laboratory based on the choice of Rh blood type with the same mother, ABO blood type The same blood transfusions were performed in 2 children with 1 transfusion of blood (RBC 800ml / time) and 7 transfusions (RBC 40ml × 4 and 80ml × 3) in 2 children. Conclusion The complete diagnosis of Rh HDN can avoid post-transfusion hemolysis due to Rh blood group incompatibility, reduce the frequency of blood transfusions and reduce the mortality and morbidity of Rh DHN.