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目的探讨经外周动静脉全自动换血术治疗高胆红素血症的效果及其对血气、电解质、生化代谢的影响。方法对34例重度高胆红素血症新生儿采用经外周动静脉同步全自动换血疗法,监测换血前后血气、电解质、血常规、血生化指标的变化。结果本组血清总胆红素换血前、后分别为(430.33±121.92)μmol/L和(216.83±63.66)μmol/L(P<0.01),总胆红素换出率49.8%。换血后血钙、血白细胞、血小板明显下降(P<0.01),术前贫血纠正。换血过程中心率、呼吸、血压无明显波动。结论全自动换血术具有较高的胆红素换出率,操作简便、安全,是治疗新生儿重度高胆红素血症的理想方法。
Objective To investigate the effect of percutaneous transluminal arteriovenous transfusion on hyperbilirubinemia and its effects on blood gas, electrolytes and biochemical metabolism. Methods Thirty-four neonates with severe hyperbilirubinemia were treated with peripheral arteriovenous synchronized automatic blood exchange therapy to monitor the changes of blood gas, electrolyte, blood routine and blood biochemistry before and after blood transfusion. Results The levels of total bilirubin before and after transfusions were (430.33 ± 121.92) μmol / L and (216.83 ± 63.66) μmol / L respectively (P <0.01) and the total bilirubin exchange rate was 49.8%. Transfusion of blood calcium, white blood cells, platelets decreased significantly (P <0.01), preoperative anemia corrected. Exchange rate of heart rate, breathing, blood pressure no significant fluctuations. Conclusion Automatic exchange transfusion with high bilirubin turnover rate, easy to operate, safe, is the ideal treatment for neonatal severe hyperbilirubinemia.