新生儿高胆红素血症471例临床分析

目的 分析新生儿高胆红素血症的高危因素,建立重点监测、及早发现和早治疗病理性黄疸的方法,减少胆红素脑病的发生.方法 选取2012年5月至2013年4月我院新生儿科收治的471例新生儿高胆红素血症患儿,回顾性分析新生儿高胆红素血症的病因和3例胆红素脑病的临床资料.结果 本研究中,新生儿高胆红素血症已明确病因的排位依次是围生因素（54.99％）、血液系统方面的原因（12.74％）、感染（4.46％）；3例胆红素脑病的病因无一例是溶血性疾病,与围生因素和家长不重视有关.结论 新生儿黄疸是新生儿期常见的疾病,14.52％患新生儿高胆红素血症（这个比例比实际低）,不及时治疗会发生胆红素脑病,留下后遗症,影响预后.从孕期开始对家长进行黄疸知识的普及,新生儿科医生进驻爱婴区查房,对存在高危因素的婴儿重点监测,对出院病人动态随访,是早期发现新生儿高胆红素血症和预防胆红素脑病的最有效预防干预措施；对高胆红素血症应尽早采取首选光疗加药物辅助治疗的综合方法,减少胆红素脑病的发生.

Clinical analysis of 471 cases of neonatal hyperbilirubinemia

Objective To analyze risk factors of neonatal hyperbilirubinemia,to find a way of giving special supervision,early detection and early treatment of pathological jaundice,to reduce the occurrence of bilirubin encephalopathy.Methods We chose 471 cases of neonatal hyperbilirubinemia admitted in Neonatology Department of our hospital from May 2012 to April 2013 as the research objects,a retrospectively analysis was carried out for the cause of neonatal hyperbilirubinemia and the clinical data of 3 cases of bilirubin encephalopathy.Results In this study,perinatal factors were the most important clear etiology of neonatal hyperbilirubinemia,accounting for 54.99％,followed by blood system reasons,accounting for 12.74％,the third etiology was the infection,accounting for 4.46％; in 3 cases of bilirubin encephalopathy,none of them were caused by hemolytic disease,in fact,it was relevant to the perinatal factors and the parents＇ ignorance.Conclusion Neonatal jaundice was a common disease of infants.14.52％ of them had neonatal hyperbilirubinemia （this proportion was lower than the actual）,if we do not treat the disease in time,it will cause sequel and have influence on the prognosis.The most effective ways to discover neonatal hyperbilirubinemia and prevent bilirubin encephalopathy are：popularization of the jaundice knowledge from pregnancy for new parents,ward rounds of pediatrician in baby area,special supervision for the infants with risk factors of neonatal hyperbilirubinemia,dynamic follow-up to discharged patients; to reduce the occurrence of bilirubin encephalopathy,those of neonatal hyperbilirubinemia should be suggested to adopt the treatment of phototherapy and drug as early as possible.