静脉使用丙种球蛋白对新生儿ABO溶血病治疗效果评估.docVIP

静脉使用丙种球蛋白对新生儿ABO溶血病治疗效果评估 　　【摘要】目的：探讨新生儿ABO溶血病使用丙种球蛋白的疗效。方法：选取我院收治的68例ABO溶血病患儿作为研究对象，其中38例患儿在明确为ABO溶血病后即静脉使用丙种球蛋白，纳入观察组，30例未使用丙种球蛋白，纳入对照组，两组患儿其余均采取光疗、口服苯巴比妥、尼可刹米、补液、白蛋白等综合治疗措施，比较两组患儿的治疗效果。结果：观察组中有1例（2.63%）血红蛋白水平低于100g/L，对照组有5例（16.67%），组间比较差异具有统计学意义（Plt;0.05）;观察组患儿的住院时间、光疗时间均明显比对照组更短，相同光疗时间胆红素下降比对照组更快，7d血红蛋白水平比对照组更高，Plt;0.05，差异均具有统计学意义。结论：针对ABO溶血病高危新生儿，静脉使用丙种球蛋白可以阻断溶血、快速降低血清胆红素防止胆红素脑病、缩短黄疸病程、防止贫血、避免或减少换血治疗。 　　 Aim： To discuss the effect of intravenous immune globulin（IVIG） on ABO hemolytic disease of newborn.Methods： We enrolled those infants （n=68） with ABO hemolytic disease who were admitted to Zunyi First People’s Hospital. The observation group （n=38） was treated with IVIG as soon as diagnosed with ABO hemolytic disease. The control group （n=30） wasn’t treated with IVIG. Both of them were given to phototherapy， oral phenobarbitone， nikethamide， fluid infusion， albumin and other comprehensive treatments， then compared their therapeutic effect.Results： The hemoglobin（HGB） level of only one infant（2.63%） in the observation group was under 100g/L while there were five（16.67%） in the control group， there was a statistical significance between the two groups（Plt;0.05）; duration of admission， and the duration of phototherapy in the observation group were shorter than those in the control group. The value of total serum bilirubin（TSB） decreased faster than that in the control group when accepting the same duration of phototherapy. The level of HGB in the 7th day was higher than that of control group. Plt;0.05， the differences were statistically significant.Conclusion： The use of IVIG in the newborns with high risk of ABO hemolytic disease can cut off hemolysis， decrease TSB rapidly to avert bilirubin encephalopathy， shorten the duration of jaundice， guard against anemia， avoid or reduce the chance of exchange transfusion. 　　【关键词】ABO溶血病;丙种球蛋白;新生儿; 　　 早期的诊断和治疗，直接关系到新生儿溶血病的预后，所以新生儿ABO溶血的关键是控制溶血，治疗主要为光疗、白蛋白、肝酶诱导剂、支持及对症，对于重症溶血者常需用一次或多次换血，而换血对机体内外环境影响很大，容易出现贫血、酸中毒、电解质紊乱等并发症[1