Serum Ionized Calcium, Total Calcium, Magnesium, and Phosphorus of Neonates During Exchange Transfusion

新生兒換血時血清離子鈣、鈣、鎂及磷的變化

陳家玉(Jia-Yuh Chen) ； 劉勝立(Sheng-Li Liu) ； 許績男(Jr-Nan Sheu) ； 徐文英(Wen-Ying Hsu) ； 陳弘基(Horn-Chi Chen)

《Acta Paediatrica Sinica》 28卷3期 (1987/06) Pp. 150-156

摘要

我們把32位患有新生兒高膽紅素血症而須作交換輸血的新生兒分為二組。第一組含有16位其平均出生體重為2.94±0.6公斤，換血前的平均膽紅素值為24.1±3.31mg/dl。第一組在換血中都沒有給予calcium gluconate。第二組含有16位其平均出生體重為3.0±0.5公斤，換血前的平均膽紅素值為26.52±4.68 mg/dl。第二組在換血中每換100 ml的血我們都給予1 ml的10% calcium gluconate。所有用來作交換輸血的血都以CPD作為抗凝劑。換血前，換血至250 ml，剛換完血，換血後第24小時及換血後第48小時我們都抽血檢查其血情離子鈣、鎂、鈣及磷值。
我們的結果顯示第一組及第二組的新生兒在換血中及剛換完血時其血清離子鈣值都明顯的降低。換血後第24及48小時則恢復正常。血清鎂值在換血中，換血後這兩組新生兒都沒有明顯的變化。血清鈣值在第一組則沒有明顯變化，但在第二組在換血中及剛換完血時血清鈣值明顯上升，換血後第24及48小時則恢復正常。這兩組的新生兒其磷值在換血中及剛換完血時都明顯上升，換完血後第24及48小時其磷值則都恢復正常。這32位接受交換輸血的新生兒在換血中雖然離子鈣值有時降至2.5 mg/d1以下但都沒有發生手足搐搦。第二組的新生兒在換血中雖然每換100 ml的血我們都給予1 ml 的10% calcium gluconate，但仍不能防止換血中離子鈣值的降低。我們建議用CPD血來作交換輸血時不須例行地每換100 ml的血給予1 ml的10% calcium gluconate。

並列摘要

Thirty-two newborn infants with. hyperbilirubinemia requiring exchange transfusion were studied and divided into two groups. Group 1 (including 16 newborn infants) received no calcium gluconate during exchange transfusion, whereas 1 ml of 10% calcium gluconate was infused for every 100 ml of blood exchanged in Group 2 (including 16 newborn infants). Citrate-phosphate-dextrose (CPD) was the anticoagulant in the blood used for exchange transfusion and in each. case, the donor blood was less than three days old.
Our data showed that serum ionized calcium decreased significantly (P＜0.01) during the period of the exchange transfusion and this was not Prevented by the infusion of 1 ml of 10% calcium gluconate per each deciliter of exchanged blood. The administration of calcium gluconate during exchange Transfusion caused significant (P＜0.01), but transient increase of serum total calcium levels. Even though serum ionized calcium decreased to levels below 2.5 mg/dl during the exchange transfusion, vetany was never found in the present study.
Twenty-four hours and foriy-eight hours after the end of the exchange transfusion, all the mean serum ionized calcium, magnesium, total calcium, and phosphorus values returned to normal levels. It is suggested that the administration of calcium gluconate during exchange transfusion is not needed unless the electrocardiogram, clinical assessment, and laboratory data suggest hypocalcemia.

並列關鍵字

ionized calcium ； magnesium ； total calcium ； phosphorus