Application Study of Intravenous Immunoglobulin Combined with Synchronous Blood Exchange Therapy for Neonatal Hemolytic Disease

Li Mengwei; Fu Yanan

doi:10.3969/j.issn.1004-5775.2025.13.015

Abstract：Objective:To explore the clinical effect of intravenous immunoglobulin combined with synchronous blood exchange therapy in the treatment of HDN.Methods:A prospective study was conducted on 85 children with HDN admitted to the hospital from March 2020 to March 2023.They were randomly divided into a transfusion group(42 cases)and a combination group(43 cases)using computer randomization.The transfusion group received peripheral arterial and venous rapid synchronous transfusion therapy,while the combination group received intravenous injection of immunoglobulin in addition to the transfusion group.The treatment effects of the two groups of children were compared.Results:TBiL,DBiL,IBiL,hs-CRP and PCT of the combined group were lower than those of the exchange transfusion group,and the differences were statistically significant(t=3.642,2.605,3.394,5.020,6.706;P＜0.05).The blood potassium was lower than that of the exchange transfusion group,and the average blood calcium,sodium and chloride levels were higher than those of the exchange transfusion group,and the differences were statistically significant(t=3.865,3.862,2.761,2.138;P＜0.05).The muscle tone,primitive reflex and general response scores were higher than those of the exchange transfusion group,and the differences were statistically significant(t=2.766,3.113,2.907;P＜0.05).The incidence of neurological sequelae was lower than that of the exchange transfusion group,and the differences were statistically significant(χ2=6.432,P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(χ2=0.238,P＞0.05).Conclusion:Intravenous injection of immunoglobulin combined with synchronous blood exchange therapy in the treatment of children with HDN can reduce their bilirubin level,alleviate their inflammatory response,correct their electrolyte imbalance,improve their neurodevelopment,and reduce the risk of neurological sequelae with high safety.