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目的:探索一种简单、有效的对非严重细菌感染(Seriousbacterialinfection,SBI)的病理性黄疸新生儿的早期鉴别方法,为减少抗生素使用提供有效依据。方法:选取2005年6月～2008年1月入住新生儿科的病理性黄疸新生儿为研究对象。患儿情况完全符合预先确定的低位SBI指标体系者视为SBI低危组,其他则归为SBI高危组,比较两组SBI发病率并推断该指标体系对黄疸新生儿SBI的阴性预测值。结果:在217例病理性黄疸新生儿中,SBI低危组共134例,共6例(4.48%)最终被确诊为SBI;相对于SBI高危组83例中有23例(27.71%)确诊为SBI,其差异有统计学意义(P<0.001)。该指标体系对SBI的阴性预测值(Negativepredictivevalue,NPV)为95.52%(95%可信区间为92.02%～99.02%)。结论:该指标体系对排除黄疸新生儿为SBI简单、快速、可靠,具有一定临床指导意义。
Objective: To explore a simple and effective method for early identification of neonatal pathological jaundice in patients with non-severe bacterial infections (SBI), and to provide an effective basis for reducing the use of antibiotics. Methods: From June 2005 to January 2008 neonatal pathological jaundice admitted to neonatal as the research object. Patients with complete compliance with the pre-determined low SBI index system were considered SBI low risk group, others were classified as SBI high risk group, SBI incidence was compared between the two groups and extrapolated to the indicator system of jaundiced neonatal SBI negative predictive value. RESULTS: Of the 217 patients with pathologic jaundice, 134 were SBI-low-risk group (6 cases, 4.48%) were finally diagnosed as SBI and 23 (27.71%) were diagnosed as SBI SBI, the difference was statistically significant (P <0.001). The SBI negative predictive value (NPV) of this index system was 95.52% (95% confidence interval was 92.02% -99.02%). Conclusion: This index system is a simple, rapid and reliable SBI for neonates with jaundice. It has certain clinical significance.