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目的制定广西正常足月新生儿(1~7 d)生理性黄疸血清胆红素的动态变化值,为临床诊断奠定基础。方法(1)用微量法测定560例正常足月新生儿血清胆红素,记录围产期可能与新生儿黄疸有关的因素。(2)将研究对象按血清胆红素水平分为正常组和高胆红素组,比较两组间各种围产因素对血清胆红素的影响。结果(1)正常足月新生儿出生后第二、三天出现黄疸,第四天到达高峰,峰值为(186.46±34.23)μmol/L,≥220.5μmol/L者占28.68%,峰值的95%区间的上限为253.55μmol/L;男性与女性、汉族与壮族血清胆红素值的比较差异无统计学意义(P>0.05)。(2)在围产期因素中,正常组与高胆红素组的婴儿出生体重、母亲孕次的比较差异无统计学意义(P>0.05),高胆红素组母亲年龄、孕周小于正常组(P<0.05)。结论正常足月新生儿黄疸出现的时间及峰值与国内外报告相似,将本地区正常足月新生儿出生后峰值的95%区间的上限作为生理性黄疸的上限值,当血清胆红素值≥253.55μmol/L,可作为新生儿高胆红素血症的诊断依据。
Objective To establish the dynamic change of serum bilirubin in normal term neonates (1-7 days) in Guangxi and lay the foundation for clinical diagnosis. Methods (1) Determination of 560 cases of normal full-term neonatal serum bilirubin micronization, perinatal neonatal jaundice-related factors may be recorded. (2) According to the level of serum bilirubin, subjects were divided into normal group and hyperbilirubin group. The effects of various perinatal factors on serum bilirubin were compared. Results (1) Jaundice appeared on the second and third days after birth in normal term newborns, peaked at the fourth day (186.46 ± 34.23) μmol / L, accounted for 28.68% with ≥220.5 μmol / L and peaked at 95% The upper limit of interval was 253.55μmol / L. There was no significant difference in serum bilirubin between males and females, Han and Zhuang (P> 0.05). (2) Among the perinatal factors, there was no significant difference in the birth weight and mothers’ pregnancy between the normal group and the high-bilirubin group (P> 0.05). The age and gestational age of the mother in the high-bilirubin group were less than Normal group (P <0.05). Conclusions The time and peak value of jaundice in normal full-term newborns are similar to the reports at home and abroad, and the upper limit of 95% of the peak value of postnatal normal newborn babies in this region is taken as the upper limit of physiological jaundice. When the serum bilirubin value ≥253.55μmol / L, can be used as a diagnosis of neonatal hyperbilirubinemia.