胎儿成红细胞增多症患者早期换血输血的指征。

Indications for early exchange transfusion in patients with erythroblastosis fetalis.

作者信息

Wennberg R P, Depp R, Heinrichs W L

出版信息

J Pediatr. 1978 May;92(5):789-92. doi: 10.1016/s0022-3476(78)80158-9.

Abstract

The postnatal rate of rise of the undirect bilirubin concentration was compared with cord hematocrit and bilirubin values in 44 newborn infants with Rh isoimmune hemolytic disease. Cord blood values failed to predict the severity of hyperbilirubinemia with sufficient accuracy to warrant their use as therapeutic guidelines. A statistically significant positive correlation was found between the cord serum indirect bilirubin concentration and its subsequent rise in 19 infants who had received antenatal phenobarbital therapy, but this relationship was not observed in untreated infants. The phenobarbital-treated infants had a slower postnatal rise of indirect bilirubin than did nontreated controls. There was no reliable indicator of the severity of hyperbilirubinemia other than careful monitoring of the serum bilirubin concentration during the early hours of life.

摘要

对44例患有Rh血型免疫溶血病的新生儿，比较其出生后未结合胆红素浓度的上升速率与脐血细胞比容及胆红素值。脐血值未能足够准确地预测高胆红素血症的严重程度，因而不足以作为治疗指南。在19例接受产前苯巴比妥治疗的婴儿中，发现脐血清间接胆红素浓度与其随后的上升之间存在统计学上显著的正相关，但在未治疗的婴儿中未观察到这种关系。接受苯巴比妥治疗的婴儿出生后间接胆红素的上升比未治疗的对照组要慢。除了在生命早期密切监测血清胆红素浓度外，没有可靠的指标来判断高胆红素血症的严重程度。