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目的探讨新生儿胆红素脑损伤日龄特征。方法收集我院2008年11月至2009年10月诊断为新生儿高胆红素血症患儿的临床资料,将患儿按入院日龄、发病日龄及入院前黄疸持续时间分为≤1天、2~3天、4~7天、8~14天和>14天各5组,比较各组胆红素脑损伤的发生率。结果共2253例高胆红素血症新生儿,发生胆红素脑损伤88例。出生1天内发病组血清胆红素水平为(414.6±177.8)μmol/L,胆红素脑损伤发生率最高(6.7%,29/436),随着发病日龄增大胆红素脑损伤发生率呈下降趋势。入院日龄为4~7天、8~14天两组患儿胆红素脑损伤发生率最高(6.2%,50/805;6.1%,26/428)。明确黄疸持续时间的患儿共2221例,≤1天、2~3天、4~7天、8~14天和>14天组胆红素脑损伤发生率分别为0.9%(8/915)、5.7%(34/592)、9.7%(33/340)、4.5%(11/242)、0.8%(1/132),差异有统计学意义(χ2=61.78,P=0.000)。结论血清胆红素水平是胆红素脑损伤的主要因素,胆红素脑损伤发生率与入院日龄、发病日龄、黄疸持续时间有关,对于入院日龄为4~14天的患儿仍需积极干预,选择换血治疗时应同时考虑发病日龄和黄疸持续时间。
Objective To investigate the neonatal bilirubin brain injury age characteristics. Methods The clinical data of neonates with hyperbilirubinaemia diagnosed in our hospital from November 2008 to October 2009 were collected and divided according to the age of admission, the age of onset and the duration of pre-admission jaundice Day, 2 ~ 3 days, 4 ~ 7 days, 8 ~ 14 days and> 14 days. The incidence of bilirubin brain injury in each group was compared. Results A total of 2253 newborns with hyperbilirubinemia and 88 patients with bilirubin brain injury. The level of serum bilirubin in the onset group was (414.6 ± 177.8) μmol / L within 1 day of birth, and the highest incidence of bilirubin brain injury was 6.7% (29/436). With the increasing age, the incidence of bilirubin brain injury Showing a downward trend. The hospitalization day was 4 to 7 days. The incidence of bilirubin brain injury was the highest in both groups (6.2%, 50/805; 6.1%, 26/428) after 8 to 14 days. A total of 2221 children with a definite duration of jaundice were 0.9% (8/915) for bilirubin brain injury at days 1, 2 to 3, 4 to 7, 8 to 14, and> 14, respectively , 5.7% (34/592), 9.7% (33/340), 4.5% (11/242) and 0.8% (1/132) respectively. The difference was statistically significant (χ2 = 61.78, P = 0.000). Conclusions Serum bilirubin level is the main factor of bilirubin brain injury. The incidence of bilirubin brain injury is related to the age of admission, the age of onset and the duration of jaundice. For children with admission of 4-14 days old Need to actively intervene, choose to exchange blood treatment should take into account the age of onset and duration of jaundice.