新生儿皮肤遮盖与暴露部位经皮胆红素测量值与血清总胆红素值的对比研究  

Comparison research of transcutaneous bilirubin measurement and serum bilirubin measurement during phototherapy in neonates

作　　者：赵丽华[1] 苏绍玉[1] 胡艳玲[1] 唐军[1] 万兴丽 夏斌[1] 李黎[2] 刘玉兰[1] 黄怡斐 蒲倩婷 刘昌红[1] 

机构地区：[1]四川大学华西第二医院新生儿科/出生缺陷与相关妇儿疾病教育部重点实验室,成都市610041 [2]四川大学华西第二医院病案管理科,成都市610041

出　　处：《中华护理杂志》2017年第7期835-839,共5页Chinese Journal of Nursing

基　　金：四川省卫生和计划生育委员会2016年度立项科研课题(16PJ250)

摘　　要：目的分析新生儿光照疗法中皮肤遮盖部位与暴露部位经皮胆红素测量值与血清总胆红素值的相关性,为临床在光照疗法中选择经皮胆红素测量部位提供参考依据。方法选取2016年1月29日—4月15日收治的112例高间接胆红素血症患儿作为研究对象。选取临床常用的两个皮肤暴露部位及两个遮盖部位作为经皮胆红素的测量部位。在入院时及光照疗法过程中采血监测血清总胆红素值,同时测定暴露部位与遮盖部位的经皮胆红素值。结果在光照疗法中的4个时间点,2个暴露部位的经皮胆红素测量值与血清总胆红素值相比,差异均具有统计学意义(均P<0.01)。遮盖部位中,遮盖的胸骨第二肋正中处皮肤的4次经皮胆红素测量值与血清总胆红素值相比,差异均无统计学意义(均P>0.05)。当血清总胆红素大于307.8μmol/L(18 mg/dl)时,血清总胆红素值均高于经皮胆红素测量值,差异均具有统计学意义(均P<0.01)。结论光照疗法中选择皮肤遮盖部位,尤以选择遮盖的胸骨第二肋正中皮肤测量的经皮胆红素值能更准确反映血清总胆红素水平。当血清总胆红素值大于307.8μmol/L(18 mg/dl)时,经皮胆红素测量值不能准确反映血清总胆红素水平。Objective To compare the correlation between transcutaneous bilirubin（TcB） measurement and serum bilirubin （TSB） measurement at covered and exposed skin sites during phototherapy in neonates. Methods Two sites of exposed skin and two sites of covered skin were chosen to measure the transcutaneous bifirubin. The serum bilirubin was monitored at admission and during phototherapy,while the transcutaneous bilirubin was tested and recorded at the same time of monitoring the serum bifirubin. Results A total of 112 cases were included from January 29th to April 15th in 2016. At the four monitoring points during phototherapy,the differences between the transcutaneous bilirubin of the two exposed sites and the serum bilirubin were statistically significant （P〈0.01）. For the covered site 4,there were no significant differences between transcutaneous bilirubin and serum bilirubin at every test point （P〉0.05）. When the serum bilirubin was higher than 307.8 μmol/L （18mg/dl）,the serum bilirubin measurement was larger than the transcutaneous bilirubin measurement. Conclusion The transcutaneous bilirubin level of covered skin was more close to serum bilirubin,especially when the covered median skin of the second rib was chosen to monitor the transcutaneous bilirubin. When the serum bilirubin was greater than 307.8 μmol/L（18mg/dl）, the transeutaneous bilirubin couldn＇t represent serum bilirubin quite well.

关 键 词：高胆红素血症 新生儿 光疗法 胆红素 皮肤遮盖部位 黄疸监测 

分 类 号：R722.1[医药卫生—儿科]