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目的探讨蒙古族和汉族新生儿高胆红素血症的发病情况,分析相关影响因素,为临床诊治提供依据。方法选取2014年6月-2016年5月在该院产科分娩的蒙古族(104例)和汉族(102例)足月新生儿及母亲为研究对象,记录胎龄、出生体重、性别、分娩方式、喂养方式、初乳分泌时间、胎便排出时间、胎膜早破、头颅血肿、孕期户外运动情况等。采用日本美能JM经皮胆红素测定仪监测其出生后1周内经皮胆红素值(TCB),2次/d,每天监测胆红素水平并计算峰值,比较两民族新生儿高胆红素血症发病率和影响因素,将有关高危因素进行Logistic回归分析。结果在206例新生儿中,诊断为高胆红素血症患儿88例,汉族新生儿高胆红素血症发病率高于蒙古族新生儿(χ~2=47.353,P<0.001),且峰值汉族新生儿较高;初乳分泌时间>24 h(OR=2.963)、汉族(OR=11.122)、剖宫产(OR=2.886)、人工或混合喂养(OR=4.245)、胎便排出时间>24 h(OR=4.212)、孕期活动量<6 h(OR=12.495)为发生新生儿高胆红素血症的独立危险因素。结论蒙古族足月新生儿高胆红素血症的发病率低于汉族新生儿,且黄疸程度较轻;初乳分泌时间>24 h、汉族、剖宫产、人工或混合喂养、胎便排出时间>24 h、孕期活动量<6 h为发生新生儿高胆红素血症的独立危险因素,这可能与两民族不同的生活方式、结构、环境等有关。
Objective To investigate the incidence of neonatal hyperbilirubinemia in Mongolian and Han nationality and to analyze the related influencing factors so as to provide the basis for clinical diagnosis and treatment. Methods From June 2014 to May 2016, Mongolian (104 cases) and Han (102 cases) full-term newborns and mothers in this hospital were enrolled in this study. The gestational age, birth weight, sex, mode of delivery , Feeding methods, colostrum secretion time, time of discharge of meconium, premature rupture of membranes, cranial hematoma, outdoor exercise during pregnancy and so on. Transdermal bilirubin (TCB) and 2 times / d were monitored within 1 week after birth by using MEBO transdermal bilirubin meter. The bilirubin levels were monitored daily and the peak values were calculated. The morbidity and influencing factors of hyperlipidemia were analyzed by Logistic regression. Results Among 206 newborns, 88 cases were diagnosed as hyperbilirubinemia. The incidence of neonatal hyperbilirubinemia was higher than that of Mongolian newborn (χ ~ 2 = 47.353, P <0.001) (OR = 2.126), cesarean section (OR = 2.886), artificial or mixed feeding (OR = 4.245), the time of discharge of meconium > 24 h (OR = 4.212), and activities during pregnancy <6 h (OR = 12.495) were independent risk factors for neonatal hyperbilirubinemia. Conclusion The incidence of hyperbilirubinemia in term full-term neonates of Mongolian is lower than that of Han newborns, and the degree of jaundice is mild. The secretive time of colostrum is> 24 h. Han, cesarean section, artificial or mixed feeding, > 24 h, activity <6 h during pregnancy is an independent risk factor for neonatal hyperbilirubinemia, which may be related to the different life styles, structures and environment of the two ethnic groups.