新生儿高未结合胆红素血症179例临床病因分析及防治

Etiopathogenisis,prevention and cure of 179 neonates with unconjugated bilirubinemia

目的为了探讨新生儿高未结合胆红素血症病因构成、发生规律及防治。方法对179例新生儿高未结合胆红素血症进行病因综合分析。结果(1)病因以感染因素占首位,31.28%(56/179);其次是溶血因素及围产因素,分别为26.82%(48/179)、12.29%(22/179);(2)病因与发病时间的关系:48例溶血因素及22例围产因素均发生在日龄<3d内,发病日龄>3d以感染因素为主,还有母乳性黄疸。结论早期新生儿高未结合胆红素血症以溶血因素及围产因素为主,中晚期新生儿高未结合胆红素血症则以感染因素为主。故加强围生期保健,加强预防及抗感染,减少孕期及产时并发症的发生可有效减少新生儿黄疸的发生。

Objective To investigate the etiopathogenisis, regularity, prevention and cure of unconjugated bilirubinemia in neonates. Methods Aggregate analysis was performed on etiopathogenisis of 179 neonates with unconjugated bilirubinemia. Results In the etiological factors, affectoi occupied the first place [31.28% （56/179）], followed by haemolytic factor and perinatal factor [26.82% （48/179） and 12.29% respectively]. The cause was correlative to disease onset time. 48 cases for haemolytic factor and 22 cases for perinatal factor fall ill during 3 days. When disease onset time was over 3 days, affectoi was predominant, accompanied with breast-feeding jaundice. Conclusion Early phase neonatal unconjugated bilirubinemia is mostlydue to haemolytic factor and perinatal factor;in advanced phase, affectoi is predominant. Therefor, augmentation of perinatal period health care, prevention and cure of infection, as well as reduction of complications in duration of pregnancy and intrapartum may reduce occurrence of neonatal jaundice effectively.