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目的:探讨导致新生儿换血的病因,换血前后患儿胆红素水平及血常规、血生化等内环境指标的变化。方法:对49例北京儿童医院新生儿换血病例,统计分析导致换血病因;换血前后分别检测患儿胆红素、血生化、血气分析及血常规,并进行比较。结果:49例患儿中因母婴血型不合导致换血41例,遗传型球型红细胞增多症3例,红细胞葡萄糖-6-磷酸脱氢酶缺乏症2例,原因不明的高胆红素血症患儿3例。换血治疗前后血清总胆红素和间接胆红素水平下降52%,血小板、白细胞计数显著减少。患儿的血钾、血氨明显下降(P<0.01),血钠和血钙水平换血前后差异无统计学意义(P>0.05),但血糖水平显著升高(P<0.01)。换血治疗前后血气分析指标无明显波动(P>0.05)。结论:母婴血型不合是导致新生儿换血的主要原因。换血治疗新生儿高胆红素血症可以有效降低患儿体内胆红素水平,对患儿血液内环境有一定影响。
Objective: To explore the etiology of neonatal blood transfusion, changes of bilirubin levels in children before and after transfusions, as well as changes of internal environmental indexes such as blood biochemistry and blood biochemistry. Methods: 49 cases of Beijing Children’s Hospital neonatal transfusion cases, statistical analysis led to transfusion causes; before and after transfusion were detected in children with bilirubin, blood biochemistry, blood gas analysis and blood routine, and compared. Results: 49 cases of children due to incompatible maternal and child blood transfusion in 41 cases, 3 cases of genetic polycythemia, 3 cases of erythrocyte glucose-6-phosphate dehydrogenase deficiency in 2 cases, unexplained hyperbilirubinemia 3 cases of children. Before and after transfusion of blood serum total bilirubin and indirect bilirubin levels decreased 52%, platelet, white blood cell count was significantly reduced. There was no significant difference in serum potassium and blood ammonia (P <0.01) between the two groups. There was no significant difference in blood sodium and serum calcium levels before and after blood exchange (P> 0.05), but blood glucose level was significantly increased (P <0.01). Blood gas analysis before and after the exchange of blood indicators did not change significantly (P> 0.05). Conclusion: The maternal-fetal blood group incompatibility is the main reason for newborn blood transfusion. Transfusion of blood in the treatment of neonatal hyperbilirubinemia can effectively reduce the level of bilirubin in children with a certain impact on the blood environment in children.