不同测量点对经皮肤测量胆红素数值的影响

The influence of transcutaneous bilirubin between different measurement points

目的 了解不同测量部位对经皮肤测量胆红素数值的影响,改进测量的精确性.方法 随机抽取200个新生儿,按照JM-103器械标准测量部位以及方法,每天分时段对新生儿进行头部、胸部两个部位进行经皮肤胆红素测量,对照两种不同测量方法在新生儿出生10天内的结果差异.结果 两组测量的胆红素数值具有统计学差异,且头部测量的胆红素值均比胸部测量值要高,平均差值范围从0.37～0.77,差值有统计学意义.胸部、头部两种测量方式显示新生儿胆红素值在出生后第5天达到峰值,第5天胆红素峰值测量均值为：头部测量均值12.09;胸部测量均值：11.43;胆红素测量值遵循正态分布趋势的原则,于出生后第10天恢复至出生后第1天的水平.结论 部分研究指出经皮肤测量胆红素和血清胆红素有相关性,但是头部和胸部两个测量点的测量值存在差异,且头部测量值恒高于胸部,测量点的有效性有待确定.新生儿胆红素趋势遵循正态分布原则,出生后第5天到达峰值,第10天基本回复第1天水平;遵此趋势结果有利于新生儿胆红素的监测,并对新生儿生理性黄疸的胆红素趋势判断提供了明确的统计学理论依据.

Objective To improve the accuracy of Transcutaneous Bilirubin measurement by understanding the differences between measurement point of forehead and chest. Methods Data collections are under the criteria of randomization, specifically, 200 neonatal are chosen in Guangzhou Women and Children＇s hospital, China. The research is conducted of subject＇s transcutancous bilirubin daily within the first ten day of newborns, in addition, comparing the difference of testing value between forehead point and chest point. Results Base on the result of Independent paired t-test, difference of mean value was found between measurement of forehead point and chest point, with statistically significant. Moreover, the deduction value of two points have shown statistical significant, which indicate the forehead point test had a higher value than chest point with a range of 0. 37 to 0. 77. The result of frequencies analysis shows a peak value of 12. 09 and 11.43 in bilirubin by forehead point and chest point, respectively, which appears in 5 days after born. The distribution of bilirubin proved to follow with the standard of normal distribution, inferred that the value of bilirubin should be downward as day 1 in day 10 after born. Conclusion Despite vari- ous studies have shown the positive relationship between Transcutaneous Bilirubin and Serum Bilirubin, difference of measure- ments between forehead point and chest point was found in our research. Moreover, the normal distribution of bilirubin in day 1 to day 10 after born of neonatal has shown us the trending of bilirubin, which can be definded as an criteria of neonatal monito- ring, also provide evidence on prognosis of neonatal jaundice.