新生儿高胆红素血症围产期危险因素的分析  

Analysis of the risk factors of perinatal neonatal hyperbilirubinemia

作　　者：丁晓玲[1] 沈佩芳[1] 邵波[1] 潘开宇[1] 李素芳[1] 程德勇[1] Ding Xiaoling;Shen Peifang;Shao Bo;Pan Kaiyu;Li Sufang;Cheng Deyong(The First People's Hospital of Xiaoshan District,Hangzhou City,Hangzhou,Zhejiang,311200,China)

机构地区：[1]杭州市萧山区第一人民医院

出　　处：《当代医学》2019年第34期15-18,共4页Contemporary Medicine

基　　金：杭州市卫生科技计划项目（2016B15)

摘　　要：目的分析新生儿高胆红素血症发病的围产期危险因素及其影响,为合理防治新生儿高胆红素血症提供临床依据。方法选取2017年3月至2018年5月本院新生儿病房收治的高胆红素血症患儿667例为研究对象,监测患儿血清总胆红素值(TSB),并详细记录围产期可能与高胆红素血症相关的因素,并采用单因素c2检验与多因素Logistic回归方法进一步分析血清总胆红素与围产期危险因素的关系。结果血清总胆红素在患儿性别、胎次、脐带绕颈中差异无统计学意义,在胎龄偏小、母亲高龄、母孕期妊娠合并症、剖宫产、出生后1 min Apgar评分≤7、体质量下降>10%、低血糖、开奶时间>24 h、出生后首次胎粪排出时间>24 h、胎膜早破、羊水污染、红细胞压积>0.6、头颅血肿、新生儿感染中差异具有统计学意义(P<0.05);Logistic回归分析显示,剖宫产、出生后1 min Apgar评分≤7分、体质量下降>10%、母亲高龄、母孕期妊娠合并症、胎膜早破、头颅血肿、开奶时间>24 h、首次胎粪排出时间>24 h、感染均是新生儿高胆红素血症的危险因素。结论剖宫产、出生后1 min Apgar评分≤7分、体质量下降>10%、母亲高龄、母孕期妊娠合并症、胎膜早破、头颅血肿、开奶时间>24 h、首次胎粪排出时间>24 h、感染均是新生儿高胆红素血症的高危因素,对存在一个或多个新生儿高胆红素血症危险因素的新生儿,围产期应积极给予适当的干预,可有效降低新生儿高胆红素血症的发生率,以改善预后。Objective To analyze risk factor of neonatal hyperbilirubinemia were analyzed. Methods 667 neonates with hyperbilirubinemia from Mar 2017 to May 2018 were systematically reviewed. The pathogenesis and risk factors were analyzed with single-factor analysis and Logistic regression analysis. Results The difference of gender, parity, cord around neck was not statistics significant, while they were in gestatinonal age,motherat high age, pregnant complication, cesarean section, 1 min Apgar score≤7, weight loss>10%, hypoglycemia, initiation time of breastfeeding>24 h, time of frist defecation>24 h, premature rupture of membranes, meconium stained amniotic fluid,hematokrit>0.6, cranial hematoma and infection were not statistics significant(P<0.05). Logistic regression analysis showed that cesarean section, 1 min Apgar score≤7, weight loss>10%,motherat high age, pregnant complication, remature rupture of membranes, cranial hematoma, initiation time of breastfeeding>24 h, time of frist defecation>24 h and infection were the risk factors. Conclusion Cesarean section, 1 min Apgar score≤7, bweight loss>10%, motherat high age,pregnant complication, remature rupture of membranes, cranial hematoma, initiation time of breastfeeding>24 h, time of frist defecation>24 h and infection were the high risk factors of neonatal hyperbilirubinemia.The existence of one or more risk factors, they should be given appropriate intervention in perinatal to reduce the incidence of postpartum neonatal hyperbilirubinemia and impove prognosis.

关 键 词：新生儿 高胆红素血症 围产期 危险因素 

分 类 号：R71[医药卫生—妇产科学]