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Objective To explore the cause constituents of neonatal severe hyperbilirubinemia and the clinical efficacy and safety of blood exchange transfusion treatment .Methods 142 neonates with severe hyperbilirubinemia conducted the blood exchange transfusion therapy .The levels of serum total bilirubin ,indirect bilirubin and direct bilirubin and the change of blood routine indica-tors were analyzed before and after blood exchange transfusion .Results The main causes leading to neonatal severe hyperbilirubi-nemia were bacterial infection(28 .20% ) ,glucose-6-phosphate dehydrogenase(G6PD) deficiency(27 .50% ) and pregnant women with ABO blood group incompatibility (16 .20% ) .The levels of serum total bilirubin ,indirect bilirubin ,direct bilirubin and blood routine indicators after operation in neonates with severe hyperbilirubinemia were significantly lower than those before operation , the differences were statistically significant (P<0 .05) .The total bilirubin swap exchange was (54 .40 ± 9 .90)% .The intraoperative adverse reactions rate was 3 .50% .The postoperative thrombocytopenia occurrence rate was 72 .00% .Conclusion The blood ex-change transfusion for treating neonatal severe hyperbilirubinemia possesses has clinical significance ,but the hematology and bio-chemical indicators monitoring should be strengthened for avoiding adverse reactions occurrence .
RESUMEN
Objective To understand the causes and the ratio of cause constituents in children with chronic cough in Beijing. Methods Patients with chronic cough treated at respiratory clinic of the Children' s Hospital Affiliated to Capital Institute of Pediatrics from May 2009 to April 2011 were included in this study. Etiologic diagnostic procedure suggested for children by the Subspecialty Group of Respiratory Diseases,the Society of Pediatrics,Chinese Medical Association in 2008 was implemented to manage the patients. After three - month follow - up,the etiological data was analyzed. Results Totally 213 patients with chronic cough aged 1. 1 to 14. 0 years old were enrolled,inclu-ding 40 cases(18. 8% )aged≤3 years old,134 cases(62. 9% )aged ﹥ 3 to 6 years old,and 39 cases(18. 3% ) aged ﹥ 6 years old. The majority of patients with positive allergen tests were sensitized to inhaled allergens. One child had positive result in 24 - hour esophageal pH monitoring,but his cough didn't respond well to the specific treatment for gastroesophageal reflux,so he wasn't diagnosed as gastroesophageal reflux cough. The 4 leading causes of the 213 pa-tients with chronic cough were cough variant asthma(CVA)in 92 cases(43. 2% ),CVA associated with upper airway cough syndrome(UACS)in 57 cases(26. 8% ),UACS in 28 cases(13. 2% ),respiratory infection and post - infec-tion cough(PIC)in 26 cases(12. 2% ),while other causes were found in 8 cases(3. 7% ),and unknown etiology in 2 cases(0. 9% ). The incidence of CVA ranked top 1 in all the 3 age groups,followed by PIC in ≤3 years old group, while CVA associated with UACS in the other 2 age groups. Conclusions CVA,CVA associated with UACS,UACS and PIC were the 4 leading causes for children with chronic cough in Beijing. Children in different age groups had dif-ferent constituents ratio of causes of chronic cough.