正常足月新生儿生后7d内血清总胆红素的动态变化及其影响因素分析  

Dynamic measurement on hour-specific total serum bilirubin of healthy term newborns during the first postnatal week

作　　者：陈宝昌[1] 马亚范[1] 刘桂玲[1] 任常军[1] 韩小梅[1] 李彦敏[1] 高静[1] 刘亚平[1] 

机构地区：[1]河北医科大学第一医院儿科,石家庄050031

出　　处：《中华围产医学杂志》2007年第5期309-311,共3页Chinese Journal of Perinatal Medicine

基　　金：河北医科大学第一医院青年科技基金项目（2003006）

摘　　要：目的 探讨石家庄地区正常足月新生儿血清总胆红素的动态变化，分析影响新生儿高胆红素血症的相关高危围产因素。方法 选取2002年1月至2006年1月在我院产科出生的正常足月新生儿和有产科高危因素的新生儿作为研究对象，应用微量胆红素测定仪测定各研究对象生后7d内不同时间点的末梢血总胆红素水平并分析各围产因素对新生儿黄疸的影响。结果 末梢血总胆红素于生后108h达峰值，平均为（266．6±92．9）μmol／L，第95百分位数为317．5μmol／L，随后胆红素水平缓慢下降。剖宫产、母分娩应用催产素、开奶时间延迟、首次胎粪排出延迟、红细胞增多症、低血糖者末梢血总胆红素峰值显著高于对照组（P均〈0．05）；宫内窘迫史、Apgar评分异常、体内出血、使用抗生素等围产因素对血清胆红素水平无明显影响（P均〉0．05）。结论 河北地区正常足月新生儿总胆红素峰值明显高于生理性黄疸高限；严格掌握剖宫产指征，减少催产素的应用，早期喂养，及时处理新生儿胎粪排出延迟、红细胞增多症和低血糖，也许可以有效地减少新生儿高胆红素血症的发生。Objective To study the dynamic changes of total serum bilirubin of normal term infants and its risk factors during the first postnatal week in Hebei area. Methods Term neonates born in our hospital from Jan. 2002 to Jan. 2006 were enrolled in this study. Total serum bilirubin in normal term newborns and newborns with perinatal risk factors was measured at several time points within postnatal seven days by microbilirubin measurer. And the perinatal risk factors on neonatal hyperbilirubinemia were analyzed. Results After birth, the total serum bilirubin levels increased rapidly and reached the peak level of （266. 6 ± 92.9） μmol/L at postnatal 108th hour and then fell down slowly. The 95th percentile of total serum bilirubin peak level was 317.5 μmol/L. The total serum bitirubin in the newborns with cesarean section, applications of oxytocin, delayed feeding, delayed passage of meconium, hypoglycemia and polycythemia was higher than those without such situations （P〈0.05）. Conclusions The peak of serum bilirubin level of normal term neonates in this area is higher than that of physiology jaundice. In order to reduce incidence of neonatal hyperbilirubinemia, doctors should pay more attention to control indication of cesarean section strictly, decrease applications of oxytocin, feed early, treat in time when delayed passage of meconium, hypoglycemia and polycythemia were occurred.

关 键 词：婴儿 新生 胆红素 黄疸 新生儿 危险因素 

分 类 号：R722[医药卫生—儿科]