ABSTRACT
Objective To investigate changes in serum bilirubin and internal environment,etc.of neonatal hyperbilirubinemia that before and after the treatment of peripherally arteriovenous synchronous exchange transfusion. Methods In the strict monitoring of vital signs,hyperbilirubinemia peripheral vessels exchange transfusion was applied in five cases of neonatal,and the serum bilirubin,routine blood test,electrolytes before and after the exchange transfusion were detected.Results By comparing the data before and after the exchange transfusion,the total bilirubin and indirect bilirubin decreased obviously,respectively[(414.02 ±56.04)μmol/L,(225.72 ±53.54)μmol/L,t =5.433 P =0.01,(381.82 ±44.68)μmol/L,(199.22 ±57.37 )μmol/L,t =5.615 P =0.01 ],the difference was statistically significant,and also the platelet count were decreased obviously,respectively [(199.00 ± 42.01)×109 /L,(102.00 ±17.72)×109 /L,t =4.758,P =0.001],the difference was statistically significant.After the exchange transfusion,white blood cells,hemoglobin,potassium,sodium,chloride,calcium,glucose,blood pressure, heart rate and blood PH value had decreased or increased slightly,there was no significant difference P >0.05.Cere-bral palsy and other complications did not occur after 12 months of follow -up of the five cases.Conclusion The outer peripheral arteriovenous synchronous exchange transfusion therapy for neonatal severe hyperbilirubinemia can quickly reduce serum bilirubin,and has less impact on the body environment,it is an important and effective salvage treatment of neonatal hyperbilirubinemia,thereby reducing damage to the nervous system of bilirubin.
ABSTRACT
Objective To evaluate the effects of inhalation anesthesia with low-flow sevoflurane on the renal function of neonates.Methods Forty ASA physical status Ⅰ or Ⅱ neonates undergoing abdominal surgery under general anesthesia,aged 6-28 days,weighing 1730-2928 g,were included in the study.After induction of anesthesia,anesthesia was maintained with sevoflurane inhalation using a semi-closed circuit system (FGF 1 L/min).The end-tidal concentration of sevoflurane was maintained at 2.5％-4.0％ according to the vital signs.Before induction of anesthesia,immediately after operation,and at 24,48 and 72 h after operation,blood samples from the peripheral vein and urine specimens were taken for determination of serum concentrations of creatinine (Cr),blood urea nitrogen (BUN),urinary retinol binding protein (RBP) and β-N-acetyl-glucosaminidase (NAG).A temperature probe was inserted to the center of soda lime canister.Results Compared with the baseline value at T0,no significant changes were found in the serum Cr and BUN concentrations at T1-4,urinary RBP concentrations were increased at T1,no significant changes were found in urinary RBP concentrations at T2-4,NAG concentrations were significantly increased at T2 and no significant changes were found in NAG concentrations at T1,3,4.The temperature of soda lime was (37 ± 3) ℃ at the end of operation.Conclusion Inhalation anesthesia with low-flow sevoflurane (FGF 1 L/min) produces no significant effect on the renal function of neonates.