新生儿高胆红素血症的临床分析及预防

Proventing and clinical analysis of neonate hyperbilirubinemia

目的从护理角度探讨,了解和掌握新生儿高胆红素血症的发生原因及有关因素。方法2002年8月至2006年8月,在我院分娩的新生儿5351人次,按照《实用新生儿学》诊断标准,发生高胆红素血症转入NICU治疗的204例,就新生儿高胆红素血症与孕周、出生体重、围产因素进行统计学分析。结果早产儿高胆红素血症的发生率明显高于足月儿和过期儿(P<0.01);低出生体重儿高胆红素血症的发生率明显高于正常体重和巨大儿(P<0.01);高胆红素血症的发生与妊高症、脐带因素、宫内窘迫、胎盘胎膜因素、难产、分娩前后用催产素有关系;高胆红素血症的病因与转归有关系。结论护士熟悉新生儿高胆发生的病因及有关因素,及早做出评估、判断,制定有效护理计划,并提供健康指导,对减少有害因素,降低新生儿高胆的发生率及致残率有很大意义。

Objective Understand the causes of neonate hyperbilirubinemia and related factors in order to facilitate developing effective nursing plans. Methods Among a total of 5351 neonates who were delivered at my hospital from August of 2002 to August of 2006, 204 cases who met the diagnosis of hyperbilirubinemia were referred to the Neonatal Intensive Care Unit （ NICU）, according to the diagnostic criteria of the Practical Neonatology. We conducted statistical analyses to find the related factors with hyperbilirubinemia, such as gestational age, birth weight, and other factors during the peri - birth period. Results The incidence rate of hyperbilirubinemia among premature infants was significantly higher than term infants or postmature infants （P 〈0.01 ） ; the incidence rate of hyperbilirubinemia among low - birth - weight infants was higher than normal - or over - birth - weight infants （P 〈0.01 ） ; the occurrence and recovery of hyperbilirubinemia were associated with maternal hypertension of pregnancy, factors of umbilical cord, fetal distress, factors of placenta and cord, dystocia, and maternal use of oxytocin before or after the delivery. Conclusions It is very important for nurses to understand the causes and related factors of hyperbilirubinemia. They can evaluate each neonate, make a specific, effective nursing plan, and conduct health education for parents in order to decrease the incidence rate of hyperbilirubinemia among neonates and its dysfunctional rate.