江西省儿童医院2011-2020年新生儿胆红素脑病流行病学分析  

Epidemiological analysis of neonatal bilirubin encephalopathy in Jiangxi Provincial Children′s Hospital from 2011 to 2020

作　　者：晁小云 余露 李琳[1] 晏长红[1] 郭建明[1] 万玲玲[1] 蒋文星[1] CHAO Xiaoyun;YU Lu;LI Lin;YAN Changhong;GUO Jianming;WAN Lingling;JIANG Wenxing(NICU,Jiangxi Provincial Children's Hospital,Jiangxi Province,Nanchang330006,China)

机构地区：[1]江西省儿童医院NICU,江西南昌330006

出　　处：《中国当代医药》2023年第28期139-144,149,共7页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202211186)。

摘　　要：目的分析江西省儿童医院2011—2020年新生儿胆红素脑病流行病学特点,为本地区制定干预性措施提供依据。方法采用回顾性调查方法,选取2011年1月1日至2020年12月31日在江西省儿童医院出院诊断为新生儿胆红素脑病患儿为调查对象,收集其一般情况、胆红素峰值、伴发疾病、治疗等临床资料进行统计分析。结果共收治597例胆红素脑病患儿,历年占病区总收治人数比例波动在0.50%~1.72%,呈下降趋势(P<0.05,r=-0.737);胆红素峰值>427μmol/L者占92.6%,>513μmol/L者占72.0%;80.8%为顺产;黄疸出现日龄中位数为[2.0(1.0,3.0)]d,入院日龄中位数为[6.0(4.0,7.0)]d;最常见的伴发疾病为ABO溶血(36.9%)、败血症或感染(35.8%)、产伤性出血(17.3%)、G-6-PD缺乏症(14.1%);2016—2020年间的患儿在胎龄、性别、出生体重、喂养方式、早产儿比例、入院日龄、黄疸出现日龄、最常见的伴发疾病方面与2011—2015年比较差异无统计学意义(P>0.05);胆红素脑病收治比例、体重下降≥10%比例、胆红素峰值、血清总胆红素与血清白蛋白比值、抗生素使用比例、签字出院比例均较2011—2015年下降,换血比例上升,差异有统计学意义(P<0.05)。结论2011—2020年共10年间江西省儿童医院新生儿胆红素脑病发病人数及年收治比例整体呈下降趋势;但胆红素脑病的发病人数仍多,危险因素并无太大变化,未来防治策略着重在对有ABO溶血、感染等高危因素的新生儿早期识别干预、加强随访,减少胆红素脑病的发生。Objective To analyze the epidemiological characteristics of neonatal bilirubin encephalopathy in Jiangxi Provincial Children's Hospital from 2011 to 2020,and to provide a basis for formulating intervention measures in this region.Methods A retrospective survey method was used to select the children who were diagnosed with neonatal bilirubin encephalopathy at Jiangxi Provincial Children's Hospital from January 1,2011 to December 31,2020.The clinical data such as general condition,bilirubin peak value,concomitant diseases,and treatment were collected for statistical analysis.Results A total of 597 children with bilirubin encephalopathy were admitted,and the proportion of the total number of children admitted to the ward fluctuated from 0.50%to 1.72%over the years,showing a downward trend(P<0.05,r=-0.737).The peak level of bilirubin was>427μmol/L in 92.6%patients and>513μmol/L in 72.0%patients.And 80.8%of the patients were vaginal delivery.The median age of jaundice onset was(2.0[1.0,3.0])days,and the median age of admission was(6.0[4.0,7.0])days.The most common associated diseases were ABO hemolysis(36.9%),sepsis or infection(35.8%),birth trauma hemorrhage(17.3%),and G-6-PD deficiency(14.1%).There were no significant differences in gestational age,gender,birth weight,feeding pattern,proportion of preterm infants,age on admission,age on onset of jaundice,and the most common associated diseases between 2016—2020 and 2011—2015(P>0.05).The proportion of patients with bilirubin encephalopathy,weight loss≥10%,peak bilirubin,bilirubin to albumin ratio value,antibiotic use,and signed discharge decreased,while the proportion of exchange transfusion increased,and the differences were statistically significant(P<0.05).Conclusion From 2011 to 2020,the number of cases and the annual admission proportion of neonatal bilirubin encephalopathy in Jiangxi Provincial Children's Hospital showed an overall downward trend.However,the number of cases of bilirubin encephalopathy is still large,and the risk factors have not changed

关 键 词：胆红素脑病 流行病学 黄疸 婴儿 

分 类 号：R722.1[医药卫生—儿科]