不同分娩方式足月新生儿早期高胆红素血症的比较

Early neonatal hyperbilirubinemia in full-term babies by different delivery way

目的:探讨不同分娩方式与足月新生儿早期高胆红素血症的关系。方法:回顾分析近半年出生的资料详实的足月新生儿共204例,分为剖宫产组69例和顺产组135例,比较两组间早期新生儿高胆红素血症发生率、脐血血常规、肝功能全套各项指标,对不同分娩方式导致早期新生儿高胆红素血症的病因进行分析。结果:剖宫产组与顺产组两组间早期新生儿高胆红素血症发生率差异有统计学意义(P<0.05),剖宫产组偏低;24 h内、24～48 h剖宫产组早期新生儿高胆红素血症发生率偏低(P<0.05),48～72 h剖宫产组早期新生儿高胆红素血症发生率较高,但两组比较差异无统计学意义(P>0.05)。剖宫产患儿中早期新生儿高胆红素血症组DBIL较高、PAI较低(P<0.05);顺产患儿中早期新生儿高胆红素血症组DBIL、ALT较高、TP、GLD、AKP、PLT较低(P<0.05)。结论:顺产组引起高胆红素血症的时间较早,要加强早期监测的力度并及早干预,剖宫产儿引起高胆红素血症的时间较晚,但往往程度更高,最终的高胆红素血症发生率更高,要加强随访。

Objective To Investigate early neonatal hyperbilirubinemia in full - term babies by different delivery way. Methods 204 cases of term newborns were selected, including 69 cases of cesarean sections group, 135 cases of natural birth group. The frequency of early neonatal hyperbilirubinemia and a full set of the indicators of umbilical cord blood routine blood and liver function were compared among the groups to discuss how early neonatal hyperbilirubinemia happen in full - term babies by different delivery way. Results The frequency of early neonatal hyperbilirnbinemia of the two groups was statistically different （P 〈 0. 05 ） ,lower in the cesarean sections group, especially in the first 48 hours. The umbilical cord blood DBIL of the newborns with early neonatal hyperbilirubinemia of cesarean sections group was statistically higher than the others of the group,whilePAI was lower. And DBIL,ALT was higher in the newborns with early neonatal hyperbilirubinemia of natural birth group, with TP, GLD, AKP,PLT lower. Conclusion The early detection and early intervention of hyperbilimblnemia should be enhanced in the natural birth group,and followup should be strengthened in cesarean sections group.