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目的 通过收集全国较大范围内母乳喂养新生儿生理性黄疸的调查资料 ,得出我国新生儿黄疸胆红素的峰值和平均值 ,为临床诊断奠定基础。方法 采取统一课题设计、多中心协作的方法 ,对 875例足月新生儿自生后第 1天 (2 4小时内 )开始每天监测胆红素水平直至血清胆红素峰值达 6 8 4 μmol/L以下。对其中 56例血清胆红素峰值大于 2 2 0 5μmol/L者做脑干听力诱发电位的测定。结果 (1)足月新生儿出生后第 2 - 3天开始出现黄疸 ,第 5天达高峰 ,平均峰值为 2 0 4± 54 6 9μmol/L。血清胆红素峰值超过 2 2 0 5μmol/L者占 34 4 %。 (2 )不同地区 (P <0 0 1)及不同季节 (P <0 0 5)出生的新生儿其血清胆红素值差异有显著性。 (3)在围产因素中 ,新生儿早期的胆红素水平与胎龄 (P <0 0 1)、分娩方式 (P <0 0 1)、出生后 1- 3天的生理性体重下降 (P <0 0 0 1)及红细胞压积水平 (P <0 0 0 1)密切相关。结论 足月新生儿黄疸出现的时间与国内外其他报道相似 ,但平均峰值高于既往报道的局部人群的峰值 ,更明显高于西方国家的新生儿。血清胆红素峰值超过 2 2 0 5μmol/L者占 34 4 %。 56例血清胆红素超过 2 2 0 5μmol/L的足月新生儿的脑干听力诱发电位无异常发现。提示新生儿高胆红素血症的诊断标准应高于
Objective To collect the peak value and mean value of bilirubin in neonatal jaundice in our country through collecting the survey data of neonatal physiological jaundice in a large area nationwide and lay the foundation for clinical diagnosis. Methods A total of 875 cases of full-term newborns were monitored daily for bilirubin levels until the peak of serum bilirubin reached 6 8 4 μmol / L the following. Of 56 patients with serum bilirubin peak greater than 2 2 0 5μmol / L brainstem auditory evoked potentials were measured. Results (1) Jaundice started to appear on the 2nd to 3rd days of full-term newborn after birth and reached its peak on the 5th day with an average peak value of 204 ± 54 6μmol / L. Serum bilirubin peak more than 2 2 0 5μmol / L accounted for 34 4%. (2) There was significant difference in serum bilirubin between newborns born in different regions (P <0.01) and in different seasons (P <0.05). (3) Among the perinatal factors, the level of bilirubin in early neonates was significantly lower than that of gestational age (P <0.01), mode of delivery (P <0.01), and physiological weight 1-3 days after birth P <0.01) and hematocrit levels (P <0.01). Conclusion The full-term neonatal jaundice appears similar to other reports at home and abroad, but the average peak value is higher than the peak value of the previously reported local population and more significantly higher than that of western countries. Serum bilirubin peak more than 2 2 0 5μmol / L accounted for 34 4%. 56 cases of serum bilirubin more than 2250μmol / L of full-term neonatal brainstem auditory evoked potentials found no abnormalities. Tip neonatal hyperbilirubinemia should be higher than the diagnostic criteria