PDF(Pubmed)
Abstract：
Neonatal hyperbilirubinemia is a common concern in newborns, with ABO blood group incompatibility serving as a significant risk factor for severe jaundice. This case report outlines the successful management of a 2.5 kg female infant born to a primigravida mother with ABO incompatibility-induced hyperbilirubinemia. The neonate, born at 38.4 weeks via lower segment cesarean section, exhibited signs of jaundice at 91 hours of life, prompting screening and subsequent confirmation of serum bilirubin levels 26.4. The decision was made using the American Academy of Pediatrics (AAP) and categorized the child under high risk according to age and bilirubin level to implement a complete exchange transfusion using a novel approach with two infusion pumps. The unique aspect of this case lies in introducing a two-infusion pump technique, one to infuse and one to extract blood by inserting the IV set in opposite directions in the infusion pump to perform the exchange transfusion, aiming to minimize complications associated with traditional methods. Careful handling of umbilical venous and arterial lines, coupled with aseptic precautions, sought to mitigate the risk of sepsis. The procedure, conducted over two hours, demonstrated stability in vital signs and was monitored with a transcutaneous bilirubinometer. Post-transfusion, repeat serum bilirubin tests showed a decrease in bilirubin of 10.1, indicating the success of the novel exchange transfusion method. The infant was discharged after a five-day hospital stay, showcasing this innovative approach\'s potential efficacy and safety. This case contributes to the evolving strategies in neonatal care and emphasizes the importance of tailored interventions in managing hyperbilirubinemia associated with ABO incompatibility.
摘要：
新生儿高胆红素血症是新生儿常见的问题，ABO血型不合是严重黄疸的重要危险因素。此病例报告概述了成功管理一名患有ABO不相容性引起的高胆红素血症的primigravida母亲所生的2.5公斤女婴的情况。新生儿,出生在38.4周通过下段剖宫产，在生命的91小时表现出黄疸的迹象，提示筛查和随后确认血清胆红素水平26.4.该决定是使用美国儿科学会（AAP）做出的，并根据年龄和胆红素水平对高危儿童进行分类，以使用两个输液泵的新型方法进行完全交换输血。这种情况的独特之处在于引入了双输液泵技术，一种是输注，一种是通过在输液泵中以相反方向插入IV组以进行换血，旨在尽量减少与传统方法相关的并发症。小心处理脐静脉和动脉管线，加上无菌预防措施，试图降低脓毒症的风险。程序,进行了两个多小时，表现出生命体征的稳定性，并用经皮胆红素计进行监测。输血后,重复血清胆红素测试显示胆红素下降10.1，表明新的交换输血方法是成功的。婴儿住院五天后出院,展示这种创新方法的潜在功效和安全性。此病例有助于不断发展的新生儿护理策略，并强调了量身定制的干预措施在管理与ABO不相容相关的高胆红素血症中的重要性。
