新生儿胆红素脑病危险因素与预防措施研究  

Study on the risk factors and preventive measures of neonatal bilirubin encephalopathy

作　　者：吴俊超[1] 刘军民[1] 刘华勇[1] 

机构地区：[1]湖北省随州市妇幼保健院新生儿科,441300

出　　处：《中国妇幼保健》2011年第13期1972-1974,共3页Maternal and Child Health Care of China

摘　　要：目的：探讨导致新生儿胆红素脑病的危险因素,优化其关键性预防措施。方法：回顾性分析1998年1月~2007年12月4 683例新生儿高间接胆红素血症（HB）及其中64例并发胆红素脑病（BE）的临床资料。结果：①4 683例HB患儿中的甲组2 366例为该院分娩,接受胆红素动态监测,HB得到及时治疗,无BE发生;乙组2 317例为市、县、乡镇分娩,没有动态监测胆红素并及时治疗HB,并发64例BE。甲乙两组病因分布对比,差异无统计学意义（P〉0.05）;②乙组2 317例中,1 187例接受过围产期保健服务者,并发16例BE,1 130例未接受服务者,并发48例BE,对比检验,差异有统计学意义（P〈0.01）;③导致64例BE的危险因素为：一是围产期母儿因素、溶血因素,感染因素等多病因并存,二是存在缺氧、酸中毒、低体温、低蛋白、低血糖、低热量等合并症。结论：建立健全对HB发生、发展的动态监测机制,针对病因,及早治疗HB,防治合并症,是预防或消除BE的关键措施;加强围产期保健服务,也能有效地降低BE发生率。Objective：To explore the risk factors of neonatal bilirubin encephalopathy,and optimize its key preventive measures.Methods：The clinical data of 4 683 neonates with indirect hyperbilirubinemia and 64 neonates with indirect hyperbilirubinemia combined with bilirubin encephalopathy from January 1998 to December 2007 were analyzed retrospectively.Results：Among 4 683 neonates with indirect hyperbilirubinemia,2 366 neonates in group A deliveried in the hospital received dynamic monitoring of bilirubin and they were treated timely,no bilirubin encephalopathy occurred;2 317 neonates in group B deliveried in hospitals in other cities,counties and townships didn＇t receive dynamic monitoring of bilirubin and they were not treated timely,64 neonates combined with bilirubin encephalopathy.There was no significant difference in the distribution of etiological causes between the two groups（P0.05）;in group B,1 187 neonates received perinatal health care,16 neonates combined with bilirubin encephalopathy;1 130 neonates didn＇t receive perinatal health care,48 neonates combined with bilirubin encephalopathy,there was significant difference（P0.01）.The risk factors of 64 neonates with bilirubin encephalopathy included coexistence of multiple etiological causes（maternal and fetal factors during perinatal period,hemolytic factor and infectious factor） and complications such as hypoxia,acidosis,hypothermia,low protein,hypoglycemia and low-calorie diet.Conclusion：Establishing and perfecting the mechanism of dynamic monitoring for occurrence and development of bilirubin encephalopathy,treating bilirubin encephalopathy timely targeting to the causes,preventing and treating the complications are the key measures of preventing and treating bilirubin encephalopathy;enhancing perinatal health care can reduce the incidence of bilirubin encephalopathy effectively.

关 键 词：胆红素脑病 危险因素 预防措施 新生儿 

分 类 号：R722[医药卫生—儿科]