Hosseinpour Sakha Seddigheh, Gharehbaghi Manizheh Mostafa
Tabriz University, Medical Science, Tabriz, Iran.
Turk J Pediatr. 2010 Jul-Aug;52(4):367-71.
Our goal was to determine the indications for exchange transfusion (ECT) and the rates of ECT-related adverse events in neonatal hyperbilirubinemia. We reviewed retrospectively the medical charts of all newborns that had undergone ECT over three years from January 2006 to December 2008. Causes of jaundice, demographic data of the patients, and details of ECT and ECT-related adverse events were recorded. A total of 176 ECT procedures were performed in 150 neonates in the three-year study period. The mean total serum bilirubin before ECT was 29.59 +/- 6.88 mg/dl. Those infants requiring more than one ECT had higher total serum bilirubin than neonates with single ECT, but the difference was not significant (35.66 +/- 12.21 vs. 29.12 +/- 6.30 mg/dl, p = 0.09). The most common cause of ECT was ABO incompatibility (49.3%), Rh disease (7.3%) and idiopathic (28%). Among the adverse events related to ECT, thrombocytopenia (36.4%), hypocalcemia (25.5%), apnea (20%), and infection (10.9%) were noted commonly. No case of ECT-related mortality was observed. All of the adverse events resolved completely before discharge. ABO isoimmunization was the most common cause of ECT in this study. The majority of adverse events associated with ECT are asymptomatic and reversible.
我们的目标是确定新生儿高胆红素血症换血疗法（ECT）的适应症以及ECT相关不良事件的发生率。我们回顾性分析了2006年1月至2008年12月三年间所有接受ECT治疗的新生儿的病历。记录黄疸病因、患者人口统计学数据以及ECT及ECT相关不良事件的详细情况。在为期三年的研究期间，150例新生儿共接受了176次ECT治疗。ECT前血清总胆红素平均值为29.59±6.88mg/dl。需要多次ECT治疗的婴儿血清总胆红素水平高于单次ECT治疗的新生儿，但差异无统计学意义（35.66±12.21 vs. 29.12±6.30mg/dl，p = 0.09）。ECT最常见的病因是ABO血型不合（49.3%）、Rh溶血病（7.3%）和特发性（28%）。在与ECT相关的不良事件中，常见的有血小板减少（36.4%）、低钙血症（25.5%）、呼吸暂停（20%）和感染（10.9%）。未观察到与ECT相关的死亡病例。所有不良事件在出院前均完全缓解。ABO血型同种免疫是本研究中ECT最常见的病因。与ECT相关的大多数不良事件无症状且可逆转。
