围生期足月儿高间接胆红素血症252例相关因素分析

目的 探讨围生期足月儿高间接胆红素血癌(简称高胆)的相关因素以及高胆程度.方法 对2010年3月至2011年10月收治的围生期高胆足月儿252例进行分析.结果 252例高胆患儿中,围生相关因素所致103例(40.9％),早发性母乳性黄痘63例(25.0％),ABO血型不舍溶血45例(17.9％),感染相关因素所致30例(11.9％),其他11例(4.4％).以溶血者总血清胆红素最高(328.0-176.8)μmol/L].252例高胆患儿中轻、中、重度分别占52.0％、33.7％、14.3％.重度高胆中围生相关因素所致11例(10.7％),ABO溶血14例(31.1％),早发性母乳性黄疸与感染相关因素所致各5例.252例中核黄疸3例,其中1例为巨大头颅血肿,2例为ABO溶血.结论 围生相关因素为住院足月儿高胆的主要原因,ABO溶血是导致患儿核黄疸的主要原因.

Analysis of related factors in 252 cases of full-term neonatal hyperbilirubinemia

Objective To investigate the related factors and degrees of perinatal full-term neonatal hyperbilirubinemia.Methods The clinical data of 252 full-term neonates with hyperbilirubinemia treated in our hospital from March 2010 to October 2011 were analyzed.Results Among 252 cases of hyperbilirubinemia,perinatal risk factors were in 103 cases(40.9%),early-onset breastfeeding jaundice in 63 cases(25.0%),ABO incompatibility hemolytic diseases in 45 cases(17.9%),infections in 30 cases(11.9%) and others in 11 cases(4.4%).Serum total bilirubin level was the highest in newborns with hemolytic disease.The mild,moderate and severe iaundice accounted for 52.0%,33.7% and 14.3% respectively.Among severe jaundice,ABO hemolytic disease was in 14 cases(31.1%),the perinatal risk factors in 11 cases(10.7%),infections in 5 cases and early-onset breastfeeding jaundice in 5 cases.Among 3 cases of kernicterus,1 case was giant cephalohematoma and 2 cases were ABO incompatibility hemolytic diseases.Conclusion The perinatal related factors are the main causes of full-term neonatal hyperbilirubinemia and ABO incompatibility hemolytic diseases is the main cause leading to kernicterus.