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新生儿高胆红素血症的病因分析和临床特点探讨

Analysis of etiology and clinical characteristics of neonatal hyperbilirubinemia

摘要:

目的 探讨新生儿高胆红素血症发病因素和临床特点,为预防和治疗提供依据.方法 回顾性分析住院治疗的新生儿高胆红素血症患儿826例,监测黄疸出现时间、临床特点,并分析黄疸出现的原因.结果 ≤1d、>1 ~7d、>7d出现黄疸的例数分别为71例、471例、284例,所占比例分别为8.60%、57.02%、34.38%.黄疸的危险因素构成比排在前三位分别是母乳性黄疸、围生期因素、感染性因素,发生的例数分别为215例、206例、200例,所占比例分别为26.03%、24.94%、24.21%.ABO溶血引起的新生儿黄疸所占比例为9.44%.812例新生儿中有220例出现新生儿黄疸,其中足月产出现母乳性黄疸170例,占27.15%;早产儿出现母乳性黄疸50例,占26.88%;两者差异无统计学意义(x2=3.05,P>0.05).足月顺产出现母乳性黄疸78例,占22.94%;足月剖宫产出现母乳性黄疸120例,占36.81%;两者差异有统计学意义(x2=213.32,P<0.05).结论 新生儿黄疸的程度受多种因素的影响,与个体差异、地域、经济文化水平、种族、喂养方式、性别、遗传等均有关,因此,严密观察和鉴别新生儿黄疸,并建立积极有效的监管制度和防护措施,采取积极有效的治疗手段,对减少高胆红素血症带来的并发症有很好的效果.

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Objective To investigate the clinical characteristics and risk factors of neonatal hyperbilirubinemia.Methods The clinical data of 826 cases with neonatal hyperbilirubinemia were retrospectively analyzed.The jaundice appeared time,clinical characteristics were monitored,and the causes of jaundice appeared were analyzed.Results The jaundice cases at ≤ 1 day,> 1 ~ 7 days,more than > 7 days were 71 cases,471 cases,284 cases,accounted for 8.60%,57.02%,34.38% ;The top three risk factors of jaundice constitute were breast milk jaundice,perinatal factors,infectious factors,the cases were 215 cases,206 cases,200 cases,the proportions were 26.03 %,24.94%,24.21% ;The proportion jaundice of newborn caused by ABO hemolytic was 9.44% ;There were 220 cases of 812 cases had neonatal jaundice,including 170 cases of full-term of breast milk jaundice,the proportion was 27.15%,50 cases of preterm infants of breast milk jaundice,accounted for 26.88%,there was no significant difference(P > 0.05) ;78 cases was full-term breast milk jaundice,the proportion was 22.94%,120 cases of cesarean section appeared breast milk jaundice,accounting for 36.81%,the difference was statistically significant(P < 0.05).Conclusion The degree of neonatal jaundice is affected by many factors,which related with individual differences,geographical,economic and cultural level,race,gender,feeding methods,genetic and so on,the strict observation and identification of neonatal jaundice and the establishment of supervision system and the protection for active and effective measures,taking active and effective treatment have very good effect to reduce hyperbilirubinemia complication as well as a good effect on the prevention and treatment of neonatal hyperbilirubinemia.

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