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目的比较采用不同比例成分血换血治疗新生儿高胆红素血症的临床价值。方法选择2012年2月-2017年1月医院收治的新生儿高胆红素血症患者60例作为本次的研究对象,其中给予2∶1的去白细胞悬浮红细胞+新鲜冰冻血浆换血治疗的患儿30例作为A组,给予改良4∶1的O型去白细胞悬浮红细胞+新鲜冰冻型血浆换血治疗的患儿30例作为B组,血源选择:母婴ABO血型不合溶血病选择O型去白细胞悬浮红细胞+AB型新鲜冰冻血浆,非ABO溶血病的患儿选择与婴儿血型同型的去白细胞悬浮红细胞+新鲜冰冻血浆。并观察2组患儿经换血治疗前后的胆红素水平变化、贫血指标变化。结果 2组患儿经换血治疗前的直接胆红素及间接胆红素指标比较差异均无统计学意义(P>0.05),2组经换血治疗后的直接胆红素及间接胆红素水平均低于换血治疗前,差异有统计学意义(P<0.05)。但2组患儿经换血治疗后的直接胆红素及间接胆红素指标比较差异均无统计学意义(P>0.05)。2组患儿经换血治疗前的RBC、Hb、HCT指标无显著差异(P>0.05),2组经换血治疗后的RBC、HGB及HCT水平均低于换血治疗前,但B组RBC、Hb、HCT高于A组,差异均有统计学意义(P<0.05)。结论 2∶1及4∶1的悬浮细胞与新鲜冰冻血浆方案均可改善新生儿机体内直接、间接胆红素指标,但采取改良4:1的悬浮细胞与新鲜冰冻血浆方案对新生儿高胆红血素进行换血治疗的效果显著,可在不影响其机体内环境的情况下迅速降低血清胆红素水平,值得在临床上推广实施。
Objective To compare the clinical value of using different proportions of blood transfusion to treat neonatal hyperbilirubinemia. Methods Sixty patients with neonatal hyperbilirubinemia admitted to our hospital from February 2012 to January 2017 were enrolled in this study. The patients were treated with 2: 1 leucocyte suspension erythrocytes + fresh frozen blood transfusion Thirty children were enrolled as group A. Thirty children with modified lecithin O + levamocyte suspension plus fresh frozen blood exchange transfusion were given as group A. Group B: Blood type selection: Type O to go with ABO incompatible hemolytic disease Leukocyte suspension erythrocytes + AB fresh frozen plasma, non-ABO hemolytic disease of children with the same type of baby blood leukocyte suspension erythrocytes + fresh frozen plasma. The changes of bilirubin level and anemia index in two groups before and after transfusions were observed. Results There was no significant difference in direct bilirubin and indirect bilirubin between two groups before transfusions (P> 0.05). The levels of direct bilirubin and indirect bilirubin Were lower than before transfusion therapy, the difference was statistically significant (P <0.05). However, there was no significant difference in direct bilirubin and indirect bilirubin between two groups after transfusions (P> 0.05). There were no significant differences in RBC, Hb and HCT before transfusions in both groups (P> 0.05). The levels of RBC, HGB and HCT in two groups after transfusions were lower than those before transfusions, but the levels of RBC, Hb , HCT higher than the A group, the difference was statistically significant (P <0.05). Conclusions Both 2: 1 and 4: 1 suspension cells and fresh frozen plasma program can improve direct and indirect bilirubin indices in neonates. However, the improved 4: 1 suspension cells and fresh frozen plasma program can significantly increase neonatal hypercholesterolemia The effect of blood transfusion is obvious, which can rapidly reduce the level of serum bilirubin without affecting the internal environment of the body. It is worth to be popularized clinically.