新生儿高胆红素血症的管理——美国儿科学会及多国临床管理指南解读  

Management of neonatal hyperbilirubinemia:interpretation of the clinical management guidelines drafted by the American Academy of Pediatrics and other countries

作　　者：李茂军[1] 唐彬秩[1] 吴青[1] 阳倩[1] 梁小明[1] 邹福兰 黄蓉 陈昌辉[1] Li Maojun;Tang Binzhi;Wu Qing;Yang Qian;Liang Xiaoming;Zou Fulan;Huang Rong;Chen Changhui(Department of Pediatrics,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院儿科,成都610072

出　　处：《中华实用儿科临床杂志》2023年第3期161-168,共8页Chinese Journal of Applied Clinical Pediatrics

摘　　要：新生儿高胆红素血症在临床上表现为黄疸,是一种普遍存在且常为良性的代谢状态,但也是出生后第1周住院的重要原因。目前认为,血中胆红素是最强超氧化物,具有过氧自由基清除活性。然而,高胆红素血症不受控制或快速升高可达神经毒性浓度,引起潜在的中枢神经系统后遗症。血中胆红素的保护作用和神经毒性风险之间是否达到适当的平衡,决定了黄疸新生儿的健康状态。为规范管理新生儿高胆红素血症(黄疸),多个国家先后制订了临床实践管理指南。现整理美国儿科学会及多国指南的主要内容并做简要解读,以便国内儿科医师在临床诊治实践中借鉴和参考。Neonatal hyperbilirubinaemia,clinically presenting as jaundice,is a ubiquitous and commonly a benign metabolic condition in newborn infants.It is a leading cause of hospitalization of neonates in the first week of life.Serum bilirubin has been considered as the most potent superoxide with the peroxyl radical scavenger activity.However,uncontrolled hyperbilirubinaemia or rapidly rising bilirubin can reach a neurotoxic concentration,potentially leading to central nervous system sequelae.Thus,the health status of jaundiced newborn infants is dependent on striking an appropriate balance between the protective effects of serum bilirubin and the risk of bilirubin neurotoxicity.In order to standardize the management of neonatal hyperbilirubinemia(jaundice),many countries have developed clinical practice management guidelines.This review sorted out and briefly interpreted the main contents of clinical management guidelines for neonatal hyperbilirubinemia drafted by the American Academy of Pediatrics and other countries,aiming to provide references of clinical diagnosis and treatment practice to domestic pediatrician.

关 键 词：婴儿 新生 高胆红素血症 黄疸 管理 指南 

分 类 号：R722.1[医药卫生—儿科]