产科新生儿不同部位经皮测黄报警预值的可靠性观察

目的对比观察产科新生儿不同部位经皮胆红素（TCB）报警预值的可靠性。方法132例产科新生儿采取随机数字分组法分为正常产组和剖宫产组各66例，新生儿均于产后第4天同一时间点应用KJ8000经皮测黄仪分别测量额、胸、腹、额胸、额胸腹TCB值，TCB〉12．9mg／dl者，取得亲属同意抽取静脉血检测血清胆红素（SB），对比分析不同部位TCB及其与sB值的差异。结果两组分别有17例或21例达到TCB报警预值。两组TCB或sB相同方法及相同部位比较，差异无统计学意义（P〉0．05）；两组TCB不同部位对比，额部值最低、胸部值最高，且与其他部位同组对比差异均有统计学意义（P〈0．01）；两组sB值对比差异无统计学意义（t=1．53，P〉0．05），与不同部位TCB对比均以胸部数值差异无统计学意义（P〉0．05），而与其他部位TCB两组差异均有统计学意义（P〈0．01）。结论正常产与剖宫产新生儿术后sB对比差异无意义；TCB动态监测以胸部结果更接近SB。

Observation of reliability of TCB of different parts of neonates as predictive alarm of SB

Objective To study the reliability of transcutaneous bilirubin (TCB) of different parts of neonates as predictive alarm of serum bilirubin ( SB ). Methods 132 cases of full-term neonates in Handan Central Hospital from May to July 2010 were divided into spontaneous delivery group and cesarean section group by random number. A KJ8000 transcutaneous bilirubinmeter was used to test their TCB at forehead, chest and abdomen on the fourth day after birth. The neonates were measured SB once TCB readings were more than 12.9 mg/dl. TCB of different parts and SB of the two groups were compared. Results The spontaneous delivery group had 17 cases of the. Neonates whose TCB readings were more than 12.9 mg/dl while the cesarean section group had 21 cases. TCB and SB of the same part by the same method showed no statistical significance between the two groups (t =0. 71, 2. 0, 1.25, 1. 0, 1.5;P ＞0. 05). TCB readings of chest were of no significant difference as compared with SB of the same group ( t =1. 72, 1. 33 ; P ＞ 0. 05 ). Conclusions SB of the spontaneous delivery group and the cesarean section group was of no significant difference. TCB reading of chest was closer to SB.