Yale University School of Medicine, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA.
Am J Perinatol. 2011 Aug;28(7):557-64. doi: 10.1055/s-0031-1274504. Epub 2011 Mar 1.
The objective of this study was to examine the use of partial exchange transfusion (PET) performed for polycythemia hyperviscosity syndrome (PHS) over time. A retrospective review of 141 infants who received a PET for PHS at Yale-New Haven Hospital between 1986 and 2007 was performed, querying maternal and neonatal medical records. Patient demographics, risk factors for PHS, indications for PET, and complications associated with PET and PHS were collected. Overall, there was no change in the number of PET performed over the study period ( R(2)=0.082, P=0.192). Eighty-eight percent of patients had at least one risk factor for PHS, most commonly maternal diabetes. Over time, there was a statistically significant decrease in maternal diabetes as a risk factor for PHS. Forty percent of patients had a significant complication attributed to PHS prior to PET. Eighteen percent of patients had a complication attributed to PET. Life-threatening complications of PHS or PET were rare. In conclusion, PHS continues to be a problem observed in neonatal intensive care units, particularly in at-risk populations. PHS and PET are associated with significant complications. Well-designed studies with long-term follow up are needed to assess the risks and benefits of PET for PHS.
本研究旨在探讨部分换血术（PET）在过去用于治疗高黏滞血症候群（PHS）的使用情况。我们对 1986 年至 2007 年期间在耶鲁-纽黑文医院接受 PET 治疗 PHS 的 141 名婴儿进行了回顾性研究，查询了产妇和新生儿的病历。收集了患者的人口统计学资料、PHS 的危险因素、PET 的适应证以及与 PET 和 PHS 相关的并发症。总的来说，在研究期间 PET 的数量没有变化（R²=0.082，P=0.192）。88%的患者有至少一个 PHS 的危险因素，最常见的是母体糖尿病。随着时间的推移，母体糖尿病作为 PHS 的危险因素呈统计学显著下降。40%的患者在接受 PET 治疗前有与 PHS 相关的严重并发症。18%的患者有与 PET 相关的并发症。PHS 或 PET 的危及生命的并发症罕见。总之，PHS 仍然是新生儿重症监护病房中观察到的一个问题，特别是在高危人群中。PHS 和 PET 都与严重的并发症相关。需要进行设计良好的长期随访研究，以评估 PET 治疗 PHS 的风险和益处。
