105例新生儿高胆红素血症高危因素临床分析

Cliical analysis of high risk factors in 105 neonates with hyperbiliru binemia

目的:探讨新生儿高胆红素血症病因及相关危险因素,为临床早防早治新生儿高胆红素血症及预后判断提供参考依据。方法:回顾性分析105例新生儿高胆红素血症的病因及相关危险因素。结果:105例新生儿高胆红素血症中病因分析明确的占66.7%(70/105),主要原因有新生儿溶血病、感染、新生儿缺氧缺血性脑病、新生儿窒息、G-6-PG缺陷症、早发型母乳性黄疸、头颅血肿、肝胆疾病,与围生因素相关的占33.3%(35/105),胎膜早破、宫内窘迫、羊水粪染、高龄初产、剖宫产、出生后体重明显下降、母乳缺乏、肝内胆汁淤积症、妊娠期高血压、胎龄以及母亲产前使用催产素、镇静剂是新生儿高胆红素血症的主要危险因素。结论:积极处理孕期疾病,严格掌握剖宫产指征,减少人为催产的比例,加强高危妊娠、高危分娩的监测,积极喂养并及时处理新生儿期的并发疾病,可以有效地减少高胆红素血症的发生,改善其预后。

Objective：To analyze the high risk factors of neonatal hyperbilirubinemia and to provide the referential evidences for prevention,treatment and prognostic udgment of neonatal hyperbilirubinemia.nethods：The causes and related high risk factors in 105 cases of neonatal hyperbilinrbinemia were analyzed.Results：Seventy of 105 patients with neonatal hyperbilirubinemia （66.7%）had obvious canses.The risk factors were hemolytic disease of newborn （HDN）,infections,hypoxic-ischemic encephalopathy （HIE）, asphyxia of newborn, glucose-6-phosphate dehydrogenase defi-clency（G-6-PD）, pristine breast milk jaundice（BMJ）, haematoma of sealp, diseases of liver and gall, 35 cases （33.3%）were related to perinatal factors.The major risk factor inducing the hyperbilirubinemia was premature rupture of membranes,intrauterine embarrassment,amniotic fluid contaminated by meconium,old primiparity,cesarean section,postnatal excessive loss of weigh,lack of breast milk, cholestasis in intrahepatic bile duct, gestation period hypertension, gestational age and using oxytocin or calmative prior to dehvery.Conclusion：To deal with the diseases during gestation period actively,control indication of cesarean section strictly, decrease anthropogenic acceleration for delivery, strengthen the monitor for high risk gestation and delivery,feed actively and treat neonatal diseases in time are helpful to reduce incidence of hyperbilirubinemia as well as improve the prognosis.