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目的:探讨经外周动静脉双泵换血术治疗高胆红素血症对内环境的影响。方法:对33例重度高胆红素血症新生儿采用经外周动静脉同步双泵换血疗法,并与手动换血31例重度高胆红素血症新生儿进行比较,监测换血前后血常规、血生化指标的变化。结果:双泵组血清总胆红素换血前和换血后分别为(425.47±91.33)μmol/L和(178.97±53.32)μmol/L(P<0.01),总胆红素换出率为(56.06±11.60)%;手动组血清总胆红素换血前和换血后分别为(405.44±107.47)μmol/L和(175.72±59.02)μmol/L(P<0.01),总胆红素换出率为(55.82±8.12)%。两组换血后血红蛋白均无明显变化,白细胞、血小板、血游离钙、血钾、血氯、及血钠均有所下降,但均在正常值之内。换血后血糖双泵组正常,手动组增高。换血过程中手动组部分心率及血压有波动,双泵组心率及血压均稳定。结论:经外周动静脉双泵控制换血能有效降低血中胆红素浓度,能更好地维持内环境及生命体征稳定,且操作简便、安全,值得推广。
Objective: To investigate the effect of peripheral arteriovenous double pump transfusion on the internal environment of hyperbilirubinemia. Methods: Thirty-three newborns with severe hyperbilirubinemia were treated with peripheral arterial-venous synchronized double-pump transfusion and compared with 31 cases with severe hyperbilirubinemia. The blood and blood levels Biochemical changes. Results: The levels of total bilirubin in the dual pump group were (425.47 ± 91.33) μmol / L and (178.97 ± 53.32) μmol / L before and after transfusions (P <0.01) ± 11.60)%. The levels of total bilirubin in the manual group were (405.44 ± 107.47) μmol / L and (175.72 ± 59.02) μmol / L, respectively (55.82 ± 8.12)%. There was no significant change in hemoglobin after transfusion in both groups. Leukocytes, platelets, free calcium, serum potassium, blood chlorine, and serum sodium decreased, but both were within normal values. Blood glucose double pump group normal, manual group increased. In the process of blood exchange, some heart rate and blood pressure of the manual group fluctuated, and the heart rate and blood pressure of the double pump group were stable. Conclusion: The transfusion of peripheral arterial and venous double pumps can effectively reduce the concentration of bilirubin in the blood, maintain the stable internal environment and vital signs, and is easy and safe to operate. It is worth to be popularized.