新生儿病理黄疸928例病因及治疗分析

目的 探讨新生儿病理件黄疸的病因及其相关危险因素以及早期合理治疗对防止胆红素脑病的积极意义.方法 本文对我院2004年1月至2008年12月住院的928例新生儿病理性黄疸患儿进行病因的相关危险因素分析,并给予适当的治疗分析.结果 928例新生儿病理性黄疸病因分析中有明确病因的占68.7%(638/928),主要有新生儿感染、新生儿溶血病、新生儿窒息、母乳性黄疸、头颅血肿、早产儿、肝胆疾病及遗传代谢性疾病;与围产因素相关的占56.6%(525/928),包括宫内窘迫、新生儿窒息、剖宫产、使用催产素、镇静剂、羊水污染、妊娠高血压.糖尿病是病理性黄胆的主要危险因素,不明原因占16.4%(152/928).治疗主要以双面蓝光照射为主,补碱补液、再辅以相应病因等措施治疗,效果良好,极少使用丙种球蛋、血浆、白蛋白等血制品.结论 新生儿病理性黄胆病因多,有些患儿黄疸是多种因素共同作用,主要为感染性,围产因素及溶血病,不明原因亦占较重要地位;积极防治并处理孕期疾病,严格掌握剖宫产指征,减少人为的催产素及镇定剂使用,积极喂养,及时处理新生儿期的并发症.可以大大减少新生儿病理性黄疸发生率,早期治疗可改善预后.

Analysis on etiopathogenisis and therapeutic effects of 928 cases of newborn pathological jaundices

Objectives To explore, etiological and related risk factors of pathological jaundice of newborn and evaluate the effects on the bilirubin encephalopathy in early stage. Methods 928 cases of pathological jaundice in newborn were included and the related factors in etiology were analyzed. Results 68.7% of cases had conclusive etiopathogenisis The etiopathogenises relates to perinatal period were 56.6%. 16.4% was with unknown etiopathogenises. Patients were put into treatment of Blue light exposure combined with relevant measure. Gamma-globulin and albumen were less used. Conclusion It is found that infections, hemolytic diseases and perinatal period factors are main factors in etiopathogenises of bilirubin encephalopathy in newborn. The pathological jaundice of newborn could be well prevented by a series of treatments in duration of pregnancy.