论文部分内容阅读
目的探讨新生儿高胆红素血症(HB)对神经行为的影响及早期干预的临床效果。方法 205例HB患儿,根据总胆红素(TSB)水平分为轻度黄疸组(TSB为220.5~256.5μmol/L,70例)、中度黄疸组(TSB为256.6~342.0μmol/L,68例)和重度黄疸组(TSB为342.1~427.5μmol/L,67例)。采用钒酸氧化法测定三组患儿的TSB水平,采用新生儿20项行为神经测定(NBNA)分别在出生2~5、12~14、26~28 d检查3次,给予综合干预措施治疗。选取65例同龄同期健康新生儿作为对照组(TSB<220.5μmol/L),经皮测定胆红素水平。比较四组神经行为评分变化。结果血中高胆红素明显影响新生儿神经行为,当TSB>220.5μmol/L时,胆红素与相应的NBNA总分呈直线负相关(P<0.05)。治疗干预后,出生2~5 d和12~14 d时轻度黄疸组、中度黄疸组和重度黄疸组的NBNA评分均低于对照组,差异有统计学意义(P<0.05);出生26~28 d时,中度黄疸组NBNA评分为(38.5±1.3)分,重度黄疸组为(38.2±1.4)分,均低于对照组的(39.7±0.6)分,差异有统计学意义(P<0.05),但轻度黄疸组与对照组比较差异无统计学意义(P>0.05)。结论高胆红素升高时新生儿NBNA评分下降,明显影响神经行为发育,早期干预能明显改善预后。
Objective To investigate the effect of neonatal hyperbilirubinemia (HB) on neurobehavioral and the clinical effect of early intervention. Methods Totally 205 children with HB were divided into mild jaundice group (TSB 220.5 ~ 256.5μmol / L, 70 cases), moderate jaundice group (TSB 256.6 ~ 342.0μmol / L, 68 cases) and severe jaundice group (TSB was 342.1 ~ 427.5μmol / L, 67 cases). The levels of TSB in three groups of children were determined by vanadic acid oxidation method. Twenty newborn children’s behavioral neurological tests (NBNA) were performed at 3 to 5, 12 to 14 and 26 to 28 days after birth, respectively, and were given comprehensive interventions. Sixty-five healthy newborns of the same age were selected as the control group (TSB <220.5μmol / L). Percutaneous bilirubin level was measured. Neurobehavioral scores of four groups were compared. Results Serum bilirubin significantly affected the neurological behavior of neonates. When TSB> 220.5 μmol / L, the total score of bilirubin was negatively correlated with the corresponding NBNA score (P <0.05). NBNA scores in mild jaundice group, moderate jaundice group and severe jaundice group after 2 ~ 5 d and 12 ~ 14 d were lower than those in control group after treatment intervention, the difference was statistically significant (P <0.05); Birth 26 ~ 28 d, NBNA score was (38.5 ± 1.3) in moderate jaundice group and (38.2 ± 1.4) in severe jaundice group, which were all lower than those in control group (39.7 ± 0.6), P < <0.05), but there was no significant difference between mild jaundice group and control group (P> 0.05). Conclusions NBNA score of newborns is decreased when hyperbilirubinemia is elevated, and neurobehavioral development is significantly affected. Early intervention can significantly improve prognosis.