高胆红素血症足月新生儿的高危围生因素  

Analysis of High Risk Perinatal Factors for Hyperbilirubinemia in Full Term Neonates

作　　者：陈宝昌[1] 戴兰芬[2] 李彦敏[1] 任常军[1] 韩小梅[1] 高静[1] 马亚范[1] 

机构地区：[1]河北医科大学第一医院儿科 [2]河北省儿童医院呼吸内科,石家庄050031

出　　处：《实用儿科临床杂志》2008年第2期133-134,145,共3页Journal of Applied Clinical Pediatrics

基　　金：河北省科技攻关课题资助(052761629)

摘　　要：目的探讨高胆红素血症(NHB)新生儿的高危围生因素。方法应用经皮胆红素测定仪监测5616例足月新生儿出生7d内血清胆红素水平,记录围生期可能与新生儿黄疸有关的17种围生因素(性别、胎次、胎龄、母亲年龄、宫窘迫史、产式、出生体质量、催产素应用情况,Apgar评分、生后开奶时间、首次胎粪排出时间、喂养方式、出血、抗生素的应用、血糖、红细胞比容、1周内体质量下降情况),将各围生因素对黄疸的影响,分别进行单因素分析和Logistic多因素回归分析。测定48例足月黄疸新生儿经皮胆红素与血清总胆红素水平,采用直线相关与回归分析和Logistic多元回归分析。结果1.黄疸新生儿48例经皮和血清总胆红素水平为(227.89±41.53)μmol/L和(212.77±36.17)μmol/L,经直线相关分析,二者呈正相关(r=0.924P<0.001)。2.引起NHB的围生因素包括胎龄、产式、胎儿宫内窘迫、应用催产素、开奶时间延迟、胎粪排出时间延迟、喂养方式、出血、低血糖、红细胞比容和体质量下降。其中引起NHB独立的高危围生因素为胎龄、产式、开奶时间延迟、喂养方式、低血糖、红细胞增多症和体质量下降。结论加强围生期保健、提倡经阴道分娩和及早开奶是预防围生期NHB的有效措施之一。Objective To explore possible high risk perinatal factors related to neonatal hyperbilirubinemia（ NHB ）. Methods Serum bilirubin levels of 5 616 healthy neonates were continuously monitored by Transcuta-neous bilirubin（ TCB ） meter during the first postnatal week. Seventeen perinatal factors possibly related to neonatal jaundice were recorded. The affects of the perinatal factors on neonatal jaundice were analyzed by the methods of single - factor analysis and Logistic regression analysis, respectively. TCB and total serum bilirubin（ TSB ） were simultaneously measured in 48 jaundiced neonates, and then the linear correlation between the 2 index was studied. Results 1. Forty - eight jaundiced neonates TCB and TSB were （ 227.89 ± 41.53 ） μmol/L and （ 212.77 ± 36.17 ） μmol/L, there was positive correlation between them （ r = 0. 924 P 〈 0.001 ）. 2. The perinatal factors related to NHB included gestational age, labor ways, fetal distress, applications of oxy- tocin, delayed feeding, delayed passage of meconium, feeding ways, internal hemorrhage, hypoglycemia, polycythemia, body weight loss. Among them ,gestational age, labor ways, delayed feeding, breast- feeding, hypoglycemia, polycythemia and body weight loss were all independent high risk perinatal factors for NHB. Conclusion Enforcing perinatal health care, vaginal delivery and early feeding arc effective prevention ways for hyperbilirubinemia in newborns.

关 键 词：婴儿 新生 胆红素 围生因素 

分 类 号：R722.1[医药卫生—儿科]