Peterec S M
Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA.
Clin Perinatol. 1995 Sep;22(3):561-92.
Dramatic improvements have been made in the management of Rh disease. Anti-D immune globulin has reduced the incidence of Rh sensitization. Intrauterine transfusions have become routine to treat fetal anemia. Once an affected infant is born, several recent improvements in neonatal care have aided in the treatment of hyperbilirubinemia. These include improved phototherapy, such as fiberoptic delivery systems, and intravenous immunoglobulin. Experience with heme oxygenase inhibitors is accumulating, and they may prove efficacious in Rh disease. Double-volume (and perhaps single-volume) exchange transfusion remains an effective method to control hyperbilirubinemia when other therapies fail. Erythropoietin may have a role in treating late, hyporegenerative anemia. Finally, better ways to assess the risk of brain injury in patients with hyperbilirubinemia may become available. Cooperation between the obstetric and neonatal teams to treat Rh-sensitized mothers and their babies is essential.
Rh 溶血病的治疗已取得显著进展。抗 D 免疫球蛋白降低了 Rh 致敏的发生率。宫内输血已成为治疗胎儿贫血的常规手段。一旦患病婴儿出生，近期新生儿护理方面的多项改进有助于治疗高胆红素血症。这些改进包括改进的光疗，如光纤传输系统，以及静脉注射免疫球蛋白。血红素加氧酶抑制剂的应用经验不断积累，它们可能在 Rh 溶血病中证明有效。当其他治疗方法无效时，双倍量（或许还有单倍量）换血输血仍然是控制高胆红素血症的有效方法。促红细胞生成素可能在治疗晚期再生低下性贫血中发挥作用。最后，可能会出现更好的方法来评估高胆红素血症患者脑损伤的风险。产科和新生儿团队合作治疗 Rh 致敏的母亲及其婴儿至关重要。
