静脉注射用丙种球蛋白治疗新生儿溶血病观察胆红素的动态变化及临床意义.DOCVIP

临床医学论文-静脉注射用丙种球蛋白治疗新生儿溶血病观察胆红素的动态变化及临床意义 【摘要】? 目的? 探讨静脉注射用丙种球蛋白治疗新生儿溶血病的作用机制及临床效果。方法? 将106例新生儿溶血病的患儿随机分为两组即静脉注射用丙种球蛋白(IVIG)组和对照组，对照组给予常规治疗，IVIG组在上述治疗的基础上给予静脉注射用丙种球蛋白,观察血清总胆红素及间接胆红素的动态变化，血清高峰期胆红素值、黄疸消退时间、住院天数、血红蛋白、网织红细胞、红细胞的变化。结果? IVIG组血清总胆红素及间接胆红素较治疗后较对照组明显降低（P＜0.001）；IVIG组血清高峰期胆红素明显低于对照组（P＜0.001）；IVIG组血红蛋白、网织红细胞、红细胞较治疗前后无明显改变（P＞0.05）；IVIG组治疗后黄疸消退快（P＜0.01）,住院天数少（P＜0.01 ）。结论? IVIG治疗新生儿溶血病：IVIG具有免疫封闭作用，能阻止溶血过程，可迅速降低血清胆红素水平，阻止向胆红素脑病的发展，缩短病程。 　　【关键词】? 新生儿；溶血病；静脉注射用丙种球蛋白?? 　　Haemolytic disease of the newborn treated with IVIG，and to observe dynamic change of bilirubin and clinical meaning 　　【Abstract】? Objective? To study the clinical effect of haemolytic disease of the newborn by using IVIG，the mechanism of action and curative effect.Methods? Clinical observation on 106 patients with haemolytic disease of the newborn. They were randomly divided into IVIG group and control group. In control group，we used conventional treatment. On the basis of the control group,the IVIG group，we used continuously IVIG,and then observed dynamic change of the total serum bilirubin，and some changes in? peak total biliurbin value，jaundice decreases time，days in the hospital，hemoglobin， reticulocyte， red blood cells.Results? The total serum bilirubin and indirect bilirubin in IVIG group were lower than the control group(P＜0.001), the peak serum bilirubin in IVIG group was lower than the control group(P＜0.001). Hemoglobin,reticulocyte and red blood cells in IVIG group didn’t change markedly(P＞0.05) before or after treatment, jaundice decreased fast after treatment in IVIG group,days in the hospital were few(P＜0.01).Conclusion? Haemolytic disease of the newborn treated with IVIG，it has immune and close use. It can prevent haemolytic procedure，and it can lower rapidly bilirubin levels,it can lower the peak serum bilirubin levels，and prevent leading to the development of bilirubin brain desease. and shorten course of treatment. 　　【Key words】? newborn；haemolytic disease；IVIG 　　新生儿溶血病是引起新生儿病理性黄疸