| Objective: To study the application of hematopoietic therapy in neonatal hyperbilirubinemia and its adverse reactions.Methods: Sixty cases of children with hyperbilirubinemia were selected as the study subjects,all of whom were admitted to the hospital from June 2013 to June 2016 and reviewed their general information.The indications,all children are change blood source besides RH hemolytic disease,all AB blood plasma,blood type O inspissation washing red blood cells,such as mixing ratio,according to the double health,choose the art of peripheral artery and vein synchronous change,change of process strictly according to the Chinese medicine academy of pediatrics recommendation from the neonatal jaundice intervention the newborn group to develop.Contrast changes before and after the change of the patient’s blood routine indexes,blood biochemical indexes and the change of blood bilirubin index,analysis of change of the whole process within the 7 d to change the blood indexes and clinical incidence of abnormal performance.Results:(1)Children with high blood bilirubin changes before and after the change of electrolyte indicators in comparison: change before(1.98±0.29)mmol/L for the blood phosphorus index level tendency,L was(2.51±0.28)mmol/L for the blood phosphorus index level tendency/L,after compared with before the change,change blood to blood phosphorus levels increased significantly(P < 0.05).The serum calcium index level was(2.31±0.19)mmol/L before blood exchange,and the serum calcium index level was(2.62±0.27)mmol/L after the exchange of blood,and the serum calcium level was significantly increased(P < 0.05).The serum magnesium index level was(0.93±0.11)mmol/L before the change of blood,and the serum magnesium index level was(0.69 ±0.18)mmol/L after the exchange of blood,and the serum magnesium level decreased significantly after the blood exchange(P < 0.05).The serum potassium index level was(4.65±0.72)mmol/L before blood exchange,and the serum potassium index level was(3.76±0.59)mmol/L after blood exchange,and the serum potassium level decreased significantly(P <0.05)after blood exchange.The blood chlorine index level was(105.63±3.96)mmol/L before the change of blood,and the serum chlorine level was(99.85±4.27)mmol/L after the exchange of blood,and the blood chloride level was significantly decreased after the change of blood(P < 0.05).The serum sodium index level was(140.61±4.07)mmol/L before blood exchange,and the serum sodium level was(136.92±3.98)mmol/L after the blood exchange,and the serum sodium level was significantly decreased after the blood exchange(P < 0.05).(2)Children with high blood bilirubin changes before and after the changeof blood routine index change is: before the change of platelet index level(296.82±98.35)×109/L,after the change of platelet index level(100.29±37.63)×1012/L,after compared with before the change,change blood platelet levels significantly decreased(P < 0.05).The erythrocyte pressure was(43±6)%,and the erythrocyte pressure was(39±5)% after the change of blood,compared with that before the change of blood,and the erythrocyte pressure was significantly decreased after the change of blood(P < 0.05).The hemoglobin level was(149.84±27.73)g/L before the change of blood,and the hemoglobin level was(125.96±19.92)g/L after the exchange of blood,and the hemoglobin level was significantly decreased after the change of blood(P < 0.05).The level of erythrocyte before blood exchange was(4.39±0.67)×1012/L,and the erythrocyte level was(3.93±0.65)×1012/L after the change of blood,and the erythrocyte level was significantly decreased after the change of blood(P < 0.05).The level of white blood cells before blood exchange was(12.17±4.98)×109/L,and the level of white blood cells after blood exchange was(6.72±2.94)×109/L,compared to before the change of blood,the level of white blood cells decreased significantly(P < 0.05).(3)Children with high blood bilirubin changes before and after the change of albumin and bilirubin index change: change before(35.96±3.57)g/L for the albumin index level,after the change of index of albumin levels for(30.18±3.75)g/L,after compared with before the change,change blood albumin levelssignificantly decreased(P < 0.05).Before the change of index of total bilirubin level is(395.82±98.16)mmol/L,after the change of index of total bilirubin levels for(181.39±60.56)mmol/L,after compared with before the change,change blood to total bilirubin level significantly decreased(P < 0.05).Change before(379.73±98.92)mmol/L for the index of indirect bilirubin level,was(170.84±60.37)mmol/L for the index of indirect bilirubin level mu mol/L,after compared with before and change,change blood to indirect bilirubin levels significantly decreased(P < 0.05).(4)Adverse reactions in blood exchange and postoperative clinical manifestations.1 case of acidosis,1 case of renal failure,1 case of apnea,2 cases of shock,2 cases of blood transfusion,4cases of cyanosis.(5)The blood test index after blood exchange transfusion.3 cases of low chlorine concentration,4 cases of low magnesium levels,10 cases of hyponatremia,13 cases of hyperglycemia,14 cases of anemia,14 cases of hypokalemia,16 cases of hyperphosphatemia,24 cases of hypercalcemia,26 cases of thrombocytopenia.Conclusion:(1)Exchange transfusion in neonatal bilirubin levels,high treatment application has significant curative effect,but the environment is significant in the treatment may result in children with blood changes,clinical manifestations are mainly high blood sugar,hypokalemia,hypercalcemia,and thrombocytopenia.(2)It is safe to carry out blood exchange therapy under strict monitoring on the children withpure bilirubinemia with no other complications.However,in some neonates,especially premature infants,other complications or infection may result in severe adverse reactions.(3)Although the children are undergoing changes in the intraoperative or postoperative environment,most of them can recover autonomously in a short time,and do not have any effect on their discharge time.In some cases,due to premature delivery and other complications,the changes in the internal environment index will be prolonged,requiring intervention.(4)In terms of the high risk factors of children with change,should avoid the routine execution of change from ordinary,before the change of operation and the entire change process should be according to the disease conditions of different children adjust accordingly,to avoid serious adverse events. |
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