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目的:探讨钦州地区足月新生儿胆红素脑病的发病因素,为该地区该病防治提供依据。方法:系统性回顾分析2 386例足月新生儿高胆红素血症患儿的临床资料,将患儿分为胆红素脑病组(脑病组)78例,非胆红素脑病组(非脑病组)2 308例,比较分析两组患儿的病因、临床特点、预后。结果:胆红素脑病的发病率为3.3%,脑病组患儿黄疸原因前3位为ABO血型不合溶血病、葡萄糖-6-磷酸脱氢酶缺陷症(G6PDD)和感染因素,入院时日龄(168.2±72.6)h,入院时黄疸持续时间(154.8±72.5)h,血清未结合胆红素(625.26±237.8)μmol/L;非脑病组患儿黄疸明确原因前3位为原因不明、母乳性黄疸、ABO血型不合,入院时日龄(120.7±48.4)h,入院时黄疸持续时间(72.3±32.9)h,血清未结合胆红素(324.46±98.5)μmol/L,两组比较,差异具有统计学意义(P<0.05)。结论:ABO血型不合溶血病及G6PDD是钦州地区足月新生儿发生胆红素脑病的高危因素,不及时就诊而导致未结合胆红素浓度过高是引起胆红素脑病的最主要原因,加强宣传教育,提高对高胆红素血症危害性认识,对有高危因素的黄疸患儿出院后及时随访、及早干预高胆红素血症是避免胆红素脑病发生的根本措施。
Objective: To investigate the etiopathogenisis of full-term neonatal bilirubin encephalopathy in Qinzhou area and provide evidence for the prevention and treatment of this disease in this area. Methods: A retrospective analysis of 2 386 cases of full-term neonatal hyperbilirubinemia in children with clinical data, the children were divided into bilirubin encephalopathy group (encephalopathy group) 78 cases, non-bilirubin encephalopathy group Encephalopathy group) 2 308 cases, comparative analysis of two groups of children etiology, clinical features, prognosis. Results: The incidence of bilirubin encephalopathy was 3.3%. The top three causes of jaundice in children with encephalopathy were ABO incompatible hemolytic disease, G6PDD, and infection factors. The age at admission (168.2 ± 72.6) h, duration of jaundice on admission (154.8 ± 72.5) h, and serum unbound bilirubin (625.26 ± 237.8) μmol / L. The top three causes of jaundice in children with non-encephalopathy were unknown. Jaundice, ABO blood group incompatibility, age at admission (120.7 ± 48.4) h, duration of jaundice on admission (72.3 ± 32.9) h, serum unbound bilirubin (324.46 ± 98.5) μmol / L, Statistically significant (P <0.05). CONCLUSION: ABO incompatible hemolytic disease and G6PDD are risk factors of bilirubin encephalopathy in full-term newborns in Qinzhou. The most common cause of bilirubin encephalopathy is caused by not being treated promptly. Publicity and education to improve awareness of the dangers of hyperbilirubinemia, jaundice children with high risk factors after follow-up after discharge, early intervention in hyperbilirubinemia is to prevent the basic measures of bilirubin encephalopathy.