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宝宝出生仅一天就全身大换血

2017-08-24 05:56:15   中国青年网

本报讯(记者伍伟 通讯员刘姗姗 阮喆)因为与妈妈血型不合,宝宝出生后就患上了严重的溶血症,需要全身换血。目前,经过成功换血治疗后,宝宝的各项生命体征平稳。

两天前,38岁的王女士刚刚产下一子,本应沉浸在喜悦之中的一家人发现,孩子出生后皮肤越来越黄,吃奶反应也不好,家人觉得不对劲,赶紧将宝宝转到武汉市中心医院新生儿科重症监护室。医生检查发现,宝宝全身皮肤发黄,有新生儿黄疸症状,结合王女士O型RH阳性血的情况,初步诊断患儿可能患有严重溶血病。

由于情况紧急,新生儿科医护人员一边与王女士及家属沟通病情,一边进行换血前的准备,联系输血科紧急配血。征得家属同意后,医护人员立即开始进行外周动静脉同步换血,用患儿全部血容量2倍的血,将其全身血液进行置换,及时换出抗体和致敏红细胞,以减轻溶血,防止胆红素脑病发生。

王女士不解,宝宝刚刚出生才一天,怎么会得溶血症呢?新生儿科主任姜红解释,新生儿ABO溶血病的发生与母亲的血型有很大关系,如果母亲血型为O型,患儿血型为A型或B型,则母子存在ABO血型不合基础,20%的孩子可发生溶血病。在ABO血型不合溶血病中,由于O型血孕母所产生的抗A或抗B免疫抗体为IgG抗体,可通过胎盘进入胎儿循环而引起胎儿红细胞凝集溶解,从而导致血胆红素迅速上升,部分患儿可出现严重的黄疸。

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