经皮胆红素动态监测在新生儿黄疸干预治疗中的作用

目的 探讨经皮胆红素动态监测在新生儿黄疸干预治疗中的作用.方法对962例新生儿在出生后1～7 d,每天对其进行经皮胆红素动态监测.对检测结果为阳性的患儿84例采血检测血胆红素水平,比较两种方法的阳性率,同时对高胆红素血症患儿给予枯草杆菌二联活菌颗粒治疗,观察治疗后的胆血素水平变化.结果 1～7 d新生儿经皮胆红素水平分别为（81.9±8.2）μmol/L、（181.7±32.3）μmol/L、（222.9±22.4）μmol/L、（230.6±20.5）μmol/L、（235.1±22.4）μmol/L、（233.7±21.1）μmol/L、（228.9±19.6）μmol/L,平均为（234.2±22.7）μmol/L.对84例经皮胆红素检测结果为阳性的患者儿进行血液胆红素检测,胆红素水平分别为（233.7±30.2）μmol/L、（215.5±28.7）μmol/L,两者呈直线性相关（r=2.55,P＜0.05）.干预治疗后血胆红素水平为（163.4±21.7）μmol/L,明显低于治疗前的胆红素水平（232.4±28.5）μmol/L（t=5.23,P＜0.05）.结论 经皮胆红素动态监测新生儿黄疸水平具有采样方便、操作简单的优点,对于早期发现和干预治疗新生儿黄疸意义重大.

Application of percutaneous bilirubin dynamic monitoring in the treatment of neonatal jaundice

Objective To investigate the application of percutaneous bilirubin dynamic monitoring in the treatment of neonatal jaundice. Methods 962 newborns in our hospital 1 to 7 days after birth were given percutaneous bilirubin dynamic monitoring everyday. Blood bilirubin determination was done when the result was positive （84 cases）. The positive rate was compared between the two different methods. And hyperbilirubinemia newborns were treated by Medilacvita. The clinical efficacy was observed. Results Blood bilirubin levels of newborns 1 to 7 days after birth were （ 81.9 ± 8.2） μmol/L, （ 181.7 ± 32.3 ） μmol/L, （ 222.9 ± 22.4 ） μmol/L, （ 230.6 ± 20.5 ） μmol/L, （235.1 ± 22.4）μmol/L, （233.7± 21.1 ） μmol/L, （ 228.9 ± 19.6 ） μmol/L respectively, and the average level was （ 234.2 ± 22.7 ） μmol/L. Blood bilirnbin test was done in 84 newborns whose percutaneous bilirnbin results were posi- tive,the bilirnbin levels were （233.7 ± 30.2）μmol/L and （215.5 ± 28.7 ）μmol/L respectively, the result was line- arly correlated （ r = 2.55, P 〈 0.05 ）. After treatment, the blood bilirubin level was （ 163.4 ±21.7 ） μmol/L, which was obviously lower than （232.4 ± 28.5 ） μmol/L before treatment （ t = 5.23, P 〈 0.05 ）. Conclusion Percutaneous bilirubin dynamic monitoring in the neonatal jaundice has the advantages of convenient and simple. And it has great significance in early detection and intervention of neonatal jaundice.