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目的探讨换血治疗不同胎龄早产儿高胆红素血症的效果及换血前后内环境的变化。方法将采用外周动静脉同步换血治疗的102名早产儿,按胎龄分为≤32周和>32周2组,比较换血疗效及换血前后血清胆红素、电解质、血常规及血气分析等内环境指标的变化。结果 102名早产儿换血前总胆红素(TB)和间接胆红素(IB)分别为(493.36±149.69)和(473.83±152.72)μmol/L,换血后TB和IB分别为(167.16±70.34)和(161.05±68.93)μmol/L,换血后胆红素水平下降明显(P<0.05);≤32周胎龄组和>32周胎龄组换血前TB、IB为(456.86±105.79)、(444.06±101.38)和(497.33±153.62)、(477.06±157.36)μmol/L,换血后为(149.39±38.93)、(144.51±36.42)和(169.09±72.82)、(162.85±71.48)μmol/L,2组换血后胆红素水平都明显下降(P<0.05);2组换血前后血常规及血钠、血氯发生改变(P<0.05)。结论换血治疗不同胎龄早产儿高胆红素血症,能有效降低胆红素水平,疗效显著;换血可能致早产儿内环境改变,要注意监测,防止不良后果。
Objective To investigate the effect of blood transfusion on hyperbilirubinemia in preterm infants of different gestational ages and the changes of the internal environment before and after transfusion. Methods 102 preterm infants treated with peripheral arteriovenous exchange transfusion were divided into two groups according to gestational age ≤32 weeks and> 32 weeks. The efficacy of blood exchange and serum bilirubin, electrolyte, blood routine and blood gas analysis were compared Changes in environmental indicators. Results The levels of total bilirubin and indirect bilirubin were (493.36 ± 149.69) and (473.83 ± 152.72) μmol / L respectively before transfusions in 102 preterm infants. The translocations of TB and IB were (167.16 ± 70.34 ) And (161.05 ± 68.93) μmol / L, respectively. The level of bilirubin decreased significantly after exchange transfusion (P <0.05). The level of IB was (456.86 ± 105.79) (444.06 ± 101.38) and (497.33 ± 153.62) and (477.06 ± 157.36) μmol / L, respectively, and were 149.99 ± 38.93, 144.51 ± 36.42 and 169.09 ± 72.82, 162.85 ± 71.48 μmol / L (P <0.05). The levels of serum bilirubin and serum bilirubin in two groups changed significantly (P <0.05) before and after transfusion. Conclusion Transfusing transfusion of hyperbilirubinemia in preterm infants of different gestational age can effectively reduce the level of bilirubin, and the curative effect is obvious. Changing transfusion may change the internal environment of premature infants, pay attention to monitoring and prevent adverse consequences.