新生儿黄疸分级管理法在新生儿黄疸病人管理中的应用

Neonatal jaundice classification management in the management of neonatal jaundice patients

目的:研究新生儿黄疸分级管理法在新生儿黄疸患者管理中的应用效果。方法:2010组新生儿共计8 648例按经皮胆红素值超过220.6μmol/L进行光疗,对黄疸出现早、上升快的则提前光疗,血胆红素水平超过342.0μmol/L,光疗失败或有严重溶血病的进行换血治疗。2011组新生儿共计9 706例,分为高危儿、中危儿、低危儿3个不同的危险级别,根据新生儿黄疸分级管理法进行相应处理。高结合胆红素血症病人两组均除外。结果:2011组光疗比例明显低于2010组(P<0.01),2011组换血比例明显低于2010组(P<0.05),两组新生儿没有1例发生胆红素脑病。结论:对新生儿黄疸进行分级管理,能显著提高黄疸患儿的管理效率,减少过度光疗,减轻病人负担,同时又提高重症高胆红素血症的识别率,降低换血比例。

Objective： To explore the application effects of neonatal jaundice classification management on the management of neo- natal jaundice patients. Methods： Phototherapy was used to 8 648 cases of neonates （Group 2010） with transcutaneous bilirubin of more than 220. 6μmoL/L. Phototherapy was used ahead of time if jaundice appeared early or developed fast, and exchange transfusion therapy was used if serum bifirubin level was more than 342. 0 μmoL/L, phototherapy had failed or the patients suffered from severe hemolytic disease. 9 706 neonates （ Group 2011 ） were divided into high - , medium - and low - risk children, who were handled according to the the neonatal jaundice classification management. High bilirubinemia patients in the two groups were excluded. Results： Phototherapy ratio of Group 2011 was significantly lower than that of Group 2010 （P 〈 0. 01 ）, and exchange transfusion ratio of Group 2011 was significantly lower than that of the Group 2010 （P 〈0. 05 ）, no bilirubin encephalopathy occurred in the two groups. Conclusion： Classification management of neonatal jaundice can significantly improve the efficiency of the jaundice management, reduce excessive phototherapy, alleviate the burden on the pa- tients, improve the recognition of severe hyperbilirubinemia, and reduce the exchange transfusion ratio.