延边地区新生儿黄疸原因分析

Analysis on the causes of neonatal jaundice in Yanbian area

目的:探讨引起新生儿高胆红素血症的危险因素,为新生儿高胆红素血症的预防和治疗提供参考。方法:回顾性分析2010年1月～2011年5月期间于该院新生儿病房住院的高胆红素血症患儿138例,研究入选标准:出生14天之内足月儿血胆红素浓度>220.6μmol/L,出生1个月之内血胆红素浓度早产儿>255μmol/L。应用Logistic回归模型,对临床常见病因如感染、围产因素、早产、ABO溶血等进行回归分析。结果:研究组有138例,对照组有215例。肺炎、剖宫产与药物因素是引起新生儿高胆红素血症的常见原因,其次是早产与窒息。应用多因素Logistic回归分析显示,研究组与对照组相比,肺炎、新生儿窒息、颅内出血、剖宫产与药物及晚期早产因素差异存在统计学意义(P<0.05)。结论:感染和围产因素是高胆红素血症的主要原因。加强围产期保健,避免宫内感染和缺氧,提高围产技术水平,同时加强高危儿的随访及健康教育是降低高胆红素血症发生的工作重点。

Objective：To explore the risk factors inducing neonatal hyperbilirubinemia,provide a reference for prevention and treatment of neonatal hyperbilirubinemia. Methods：A total of 138 infants with neonatal hyperbilirubinemia from neonatal wards of the hospital from January 2010 to May 2011 were analyzed retrospectively.The inclusion criteria included： the blood bilirubin concentration of term infants220.6 μmol/L within 14 days after birth,the blood bilirubin concentration of premature infants255 μmol/L within one month after birth.Multivariate Logistic regression model was used to analyze the common causes in clinic,such as infection,perinatal factors,premature birth,and ABO hemolysis. Results：Study group included 138 infants,and control group included 215 infants.Pneumonia,cesarean section,and drug factors were the common causes inducing neonatal hyperbilirubinemia,followed by premature birth and asphyxia.The results of multivariate Logistic regression analysis showed that there was significant difference in the incidences of pneumonia,neonatal asphyxia,intracranial hemorrhage,the rate of cesarean section,and late premature birth factors between study group and control group（P0.05）. Conclusion：Infection and perinatal factors are the main causes of hyperbilirubinemia.Enhancing perinatal health care,avoiding intrauterine infection and anoxia,improving perinatal technical level,and strengthening follow-up and health education for high risk infants are the key points to reduce the occurrence of hyperbilirubinemia.