生理盐水与白蛋白部分换血治疗新生儿红细胞增多症对照研究

Randomized Controlled Trial of Isotonic Saline Versus Albumin in Partial Exchange Transfusion for the Treatment of Neonatal Polysythaemia

摘要:

目的 比较生理盐水与 5 %白蛋白作为置换液部分换血 (PET)治疗新生儿红细胞增多症的疗效。方法 6 2例新生儿红细胞增多症患儿被随机分配接受生理盐水 (n =30 )或 5 %白蛋白 (n =32 )PET治疗。结果 生理盐水组和白蛋白组接受PET后红细胞压积 (HCT)均显著下降 ,分别从换血前的 (0 .72± 0 .0 4)和 (0 .71±0 .0 3)降至换血后 2 4h的 (0 .5 6± 0 .0 5 )和 (0 .5 5± 0 .0 4) ,两组前后比较差异均有非常显著意义 (P <0 .0 1) ,两组间HCT比较差异无显著意义 ;两组血Na+,血K+和血总蛋白 (TP)换血后无显著影响。结论 生理盐水和 5 %白蛋白作为置换液治疗新生儿红细胞增多症疗效显著 ;生理盐水价廉、无潜在感染危险可替代白蛋白治疗新生儿红细胞增多症。

Abstract:

Objective To compare the efficacy of isotonic saline and 5% albumin as a replacement fluid in partial exchange transfusion (PET) for the treatment of neonatal polycythaemia. Methods Sixty two neonates with polycythaemia were randomly divided into two groups: PET with isotonic saline group (n=30) and PET with 5% albumin group (n=32). Haematocrit (HC) was measured before and after the treatment. Results HCT significantly declined at 24 h after PET with either saline or 5% albumin compared with that before the treatment [( 0.72 ± 0.04 ) vs. ( 0.56 ± 0.05 )]; [( 0.71 ± 0.03 ) vs. ( 0.55 ± 0.04 ), respectively; P< 0.01 ]. There was no difference between the two groups. Serum sodium, potassium, and total proteins concentrations were not significantly affected by PET in either group. Conclusions Both isotonic saline and 5% albumin are effective as replacement fluids in PET for the treatment of neonatal polycythaemia. Since isotonic saline is cheaper and free of infection, it may be the fluid of choice in PET.