新生儿胆红素脑病33例临床分析  

A retrospective study of neonatal severe bilirubin encephalopathy in 33 newborns

作　　者：徐瑞峰[1] 吴珠明[1] 高红霞[1] 易彬[1] 

机构地区：[1]甘肃省妇幼保健院新生儿救护中心,兰州730050

出　　处：《中国新生儿科杂志》2011年第6期392-395,共4页Chinese Journal of Neonatology

摘　　要：目的探讨新生儿胆红素脑病的病因及临床特点。方法选择2006年1月至2010年1月我院新生儿科收治的重症新生儿高胆红素血症患儿,分为胆红素脑病组(脑病组)与非胆红素脑病组(非脑病组),比较两组患儿病因、临床特征、胆红素水平、胆红素/白蛋白比值(B/A)以及治疗转归。结果脑病组黄疸病因以溶血性因素占首位(48.5%),其次是感染因素(24.2%);非脑病组黄疸病因主要为溶血(69.7%)。脑病组总胆红素、B/A比值、入院日龄和黄疸持续时间均大于非脑病组[(555.2±113.9)μmol/L比(431.3±62.3)μmol/L,(0.87±0.17)比(0.67±0.11),(129.5±60.7)h比(53.0±22.6)h,(81.6±39.6)h比(34.2±15.8)h,P均<0.001]。胆红素脑病警告期与痉挛期患儿入院日龄、血清胆红素及B/A比值差异无统计学意义(P>0.05)。85%的胆红素脑病患儿预后不良。结论溶血与感染是新生儿胆红素脑病的主要原因,总胆红素浓度过高和干预延迟是引起胆红素脑病的高危因素。Objective To investigate the etiology and clinical features of neonatal bilirubin encephalopathy.Methods To select severe hyperbilirubinemia infant admitted in Gansu Provincial Maternity and Children＇ s Hospital from January 2006 to January 2010,assigned into encephalopathy group and non-encephalopathy group,comparing their clinical characteristics,bilirubin level,bilirubin/ albumin ratio （B/ A） and outcome.Results The main etiology of neonatal bilirubin encephalopathy is hemolytic （48.5%）,followed by infection （24.2%）;but the etiology of non-encephalopathy is mainly for hemolysis,accounted for 69.7%.total bilirubin,B/ A ratio,admission day and jaundice duration of Encephalopathy group are larger than them in non-encephalopathy group,the difference was statistically significant,（555.2±113.9）μmol/ L vs.（431.3±62.3）μmol/ L,（0.87±0.17） vs.（0.67±0.11）,（129.5 ±60.7） h vs.（53.0±22.6） h and （81.6±39.6） h vs.（34.2±15.8） h,P0.01.Compared to the patient at the warning period and spasms period,they have the same admission age,serum bilirubin and B/ A ratio （P0.05）.85% of bilirubin encephalopathy infant have poor prognosis.Conclusions Hemolysis and infection is the main reason for the newborn bilirubin encephalopathy,too high total bilirubin concentration and the delay of intervention are the risk factors of bilirubin encephalopathy.

关 键 词：胆红素脑病 临床分析 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]