新生儿高胆红素血症484例临床分析

目的了解住院新生儿高胆红素血症的发病情况及探讨采用间歇性蓝光照射治疗新生儿高胆红素血症的疗效。方法总结分析我院2002年1月至2007年8月收治的484例高胆红素血症患儿临床资料。结果高胆红素血症发病率占同期新生儿的40．5％，引起本组高胆红素血症的病因中，围产期因素占37．4％，感染占21．6％，母乳性黄疸占18．5％，新生儿溶血占6．2％。其中发病日龄在7天以内占69％。435例治愈，49例好转。结论加强围产期保健，对所有新生儿特别是7天内新生儿应进行每天至少1次的临床评估。对所有24小时内出现黄疸的新生儿应进行经皮测胆红素及血清总胆红素的监测。对耶些在血总胆红素达到高峰水平前离院的新生儿应随访。对于出生24小时内出现黄疸，早产儿低于正常值但有高危因素，健康足月儿总胆红素〉256μmol／L，无高危因素，都应积极治疗以降低高胆红素的发病率、死亡率和伤残率。

Clinical analysis of hyperbilirubinemia in 484 newborn

Objective To observe the etiology of hyperbilirubinemia in newborn and the effects of phototherapy. Methods 484 jaundiced infants bornd in our hospital from Jan 2002 to Aug 2007 were reviewed and analyzed. Results Hyperbilirubinemia occurs 40.5% in all new born.Ther is kfactors are perinatal diseases （premature,IUGR,IDM,etc.）37.4%,infection 21.6%,breast milk jaundice syndrome 18.5%,hemolytic disease 6.2%. Conclusions All infants espicialy seven days old should be routinely assessed by clinicians at least once a day.At minimum.a transcutaneous bilirubin （TcB） or sTB（serum tatal bilirubin） measurement should be performed on each infant who is jaundiced in the first 24 hours of life and seriously considered on any jaundiced infant discharged before the maximum STB level has been reached. To reduse the incidence, mortality rate and injure rate of the hyperbilirubinemaia disease,each infant who is jaundiced in the first 24 hours of life,premature birth hanving high factors and mature whose sermum tatal bilirubin 〉256μmol/L with no high factors need phototherapy early.