经皮与血清学胆红素联合检测在新生儿病理性黄疸诊断的价值

COMBINED DETECTION OF TRANSCUTANEOUS AND SERUMAL BILIRUBIN IN DIAGNOSIS OF PATHOLOGICAL JAUNDICE OF NEONATE

目的探讨动态经皮测胆红素联合血清学最终检测对新生儿病理性黄疸诊断的临床应用价值。方法将具有病理性黄疸高危因素的足月新生儿随机分为观察组和对照组各100例。采用NJ33A经皮胆红素仪监测胆红素,联合血清学最终胆红素检测为观察组,利用传统目测观察并经血清胆红素检测为对照组。结果 2组在确诊病理性黄疸和符合黄疸干预推荐方案的足月新生儿时龄、日龄的比较,差异有统计学意义(P<0.05)。2组在新生儿生后2周后黄疸消退情况对比,差异有统计学意义(P<0.05)。利用经皮测胆红素明确新生儿病理性黄疸诊断的阳性率高达91.5%。结论对经皮测胆红素符合病理性黄疸的诊断和黄疸干预推荐方案的新生儿,同时血清胆红素最终检测,使新生儿病理性黄疸得以早期明确诊断和干预治疗,明显降低了新生儿黄疸消退延迟的发生率。

Objective To study the clinical applied value for dynamic transeutaneous bilirubin testing combined with serum bilirubin in diagnosis of pathologic jaundice of neonatal. Methods The full term neonates with the high risk factors of pathologic jaundice were randomly divided into observation group （ n = 100） and control group （ n = 100）. In observation group, bilirubin was measured by both NJ33A transcutaneous bilirubinometer and serum, and in control group, bilirubin was determined by traditional visual observation and the serum. Results There were significant difference in the hour old and day old of diagnosed pathological jaundice and recommended jaundice intervention program between the two groups （ P 〈 0.05 ）. A significant difference was observed in neonatal jaundice regression two weeks after birth between the 2 groups （ P 〈 0.05 ）. The positive rate of the neonatal pathological jaundice diagnosed by the transcutaneous bilirubin was 91.5%. Conclusion The neonates accorded with pathological jaundice diagnosis by the transcutaneous bilirubin testing and neonatal jaundice intervention program, while the final serum bilirubin test was simultaneously determined, may receive the early diagnosis and intervention treatment, and significantly reduced the incidence of delayed jaundice of neonate.