监测非感染性新生儿高胆红素血症中胆红素（经皮测）对并发肠源性败血症早期诊断的意义

目的：探讨非感染疾病新生儿高胆红素血症临床治疗中，部分发展为新生儿肠源性败血症病例的早期诊断和防治。方法对2012年1月～2013年7月我科收治的新生儿高胆红素血症患儿，监测胆红素（经皮测）数值变化，对退黄疗效不理想或黄疸不退反而升高，同时并出现相关败血症症状的及早寻找原因，必要时做相关检查以早期诊断肠源性败血症，及时采取措施。结果150例新生儿高胆红素血症中6例并发新生儿败血症，均是肠道菌，推测为肠源性败血症。结论肠源性内毒素血症和细菌移位、肠源性败血症是本组新生儿败血症的主要原因。早期诊断，及早采取防治措施是关键。

The significance of monitoring transcutaneous bilirubin in early diagnosis of concurrent enterogenous sepsis for non-infectious neonatal hyperbilirubinemia

Objective To explore the early diagnosis and treatment of neonatal enterogenous sepsis partly deriving from non-infectious neonatal hyperbilirubinemia during its clinical treatment. Methods Patients with neonatal hyperbilirubinemia who were admitted to our department from January,2012 to July,2013 were monitored the changes of transcutaneous bilirubin. The reasons for the patients with unsatisfactory jaundice elimination,exacerbated jaundice,and concurrent symptoms of sepsis were investigated and analyzed in a timely manner. Relevant examinations were carried out when necessary so as to early diagnose enterogenous sepsis and take measures timely. Results Six among 150 patients with neonatal hyperbilirubinemia were affected by concurrent neonatal sepsis. The bacteria were all enteric. Enterogenous sepsis was then speculated. Conclusion The main reasons of neonatal sepsis in the study include intestinal endotoxaemia,bacterial translocation and enterogenous sepsis. Early Diagnosis and timely prevention and treatment are crucial in the process.