新生儿高胆红素血症产科原因的探讨

Discussion on hyperbilimbinemia in neonates

目的：探讨新生儿高胆红素血症（简称高胆）的产科原因。方法：选择2003年1月～2004年12月在产科出生的新生婴儿2170例，新生儿高胆624例，按其原因分成两组，进行回顾性分析。结果：624例高胆的原因：剖宫产368例，发生率36．90％。阴道分娩256例，发生率21．80％。剖宫产组黄疸出现时间（2．52±1．04）天，高峰时间（4．49±1．32）天，胆红素峰值（272．60±30．40）μmol／L。阴道分娩组黄疸出现时间（2．53±1．05）天，高峰时间（4．63±1．38）天，胆红素峰值（268．90±32．5）μmol／L。两组黄疸出现时间及程度比较差异无显著性（P〉0．05），但两组平均胆红素峰值比较，差异有显著性（P〈0．05）。结论：剖宫产、第二产程延长、新生儿窒息可能是引起新生儿高胆的围产因素。

Objective： To investigate the factors in neonates with hyperbilimbinemia. Methods： 2 170 cases divided into two groups on their accounts were analyzed retrospectively from Jan 2003 to Dec 2004. Among them there were 624 with hyperbilinubinemia. Results： 368 cases in cesarean group was 36. 9% and 256 cases in vaginal delivery group was 21.8%. It was shown： time of jaundice （2. 52 ± 1.04） d and （2. 53 ± 1.05 ） d, peak time （4. 49 ± 1.32） and （4. 63 ± 1.38） d, and peak value of bilirubin （272. 60 ±30. 40） μmol/L and （268. 90 ±32. 50） μmol/L respectively in the former and the later. There was no significant difference in the comparison of jaundice time and its extent （ P 〉 0. 05 ） . But there was a significant difference in mean peak value of bilirubin （ P 〈 0. 05） . Conclusion： The asphyxia neonatorum may cause factors of hyperbilirubinemia with prolonged second stage of cesarean.