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目的 探讨高胆红素血症外周动静脉同步换血换血量与胆红素下降的关系。方法 对 2 5例高胆红素血症患儿采用外周动静脉同步换血 ,换血前 (0mL/kg)、换血 5 0mL/kg、10 0mL/kg和 15 0mL/kg时行胆红素系列检验。结果 高胆红素血症患儿换血后胆红素均有显著降低 ,总胆红素、间接和直接胆红素的换出率分别是46 1%、45 93 %和 44 6 4%。换血至第一个 5 0mL/kg时总胆红素换出率是 2 2 6 5 % ,第二个 5 0mL/kg时是14 94% ,第三个 5 0mL/kg时换出率是 8 5 1%。换血量 (X)与胆红素换出率 (Y)呈正相关 ,Y =3 2 6 5 +0 316 X,r =0 90 6 ,P <0 0 0 1。结论 总胆红素的下降与换血量成正比关系 ,但换出率逐渐减低。根据回归方程可预测推算所需要的换血量或换血后胆红素的水平。
Objective To investigate the relationship between the exchange transfusion volume and the decrease of bilirubin in patients with hyperbilirubinemia. Methods Twenty-five children with hyperbilirubinaemia underwent synchronous biliary extubation (before peripheral blood and vein exchange, 0 mL / kg and 50 mL / kg, 100 mL / kg and 150 mL / kg) . Results The bilirubin was significantly decreased in children with hyperbilirubinemia after transfusions, and the exchange rates of total bilirubin, indirect and direct bilirubin were 46 1%, 45 93% and 44 6 4% respectively. The total bilirubin turnover was 50% for the first 50 mL / kg, 14.94% for the second 50 mL / kg, and 8% for the third 50 mL / kg 5 1%. Exchange volume (X) and bilirubin exchange rate (Y) was positively correlated, Y = 3 2 6 5 +0 316 X, r = 0 90 6, P <0 0 0 1. Conclusion The decrease of total bilirubin is directly proportional to the amount of blood transfusion, but the exchange rate gradually decreases. According to the regression equation can predict the amount of exchange required for the calculation or exchange of bilirubin after the level of blood.