母乳性黄疸的诊断和治疗

Diagnosis and management of breast-feeding jaundice

目的 探讨母乳性黄疸的诊断和治疗。方法 1.2 2 8例住院期间均停母乳改配方奶 ;2 .每天监测血清总胆红素 (TB) ;3.TB≥ 2 2 0 .6 μmol/L者蓝光治疗 ;4.对黄疸消退较慢或出院时黄疸未完全消退者进行随访。结果 TB >2 5 5 μmol/L者 10 8例 ,其中 >34 0 μmol/L者 36例 ;停母乳后胆红素降至原来水平 5 0 %的天数为 4.0± 1.4d ;黄疸完全消退时间为 7.0± 2 .0d ;随访 110例中除 4例外余病例出院后黄疸逐渐消退。结论 诊断母乳性黄疸最可靠的依据是停母乳后未经病因治疗黄疸完全消退 ,但黄疸消退的时间有个体差异。

Objective To explore diagnosis and management of breast-feeding jaundice.Methods 1.In 228 infants, breast-feeding was temporarily discontinued, and they were fed with formula during hospital stay. 2.Serum total bilirubin (TB) levels were measured on daily basis. 3.Phototherapy was administered when TB levels were higher than 220.6 μmol/L. 4.Infants were followed up if their jaundice decreased slowly, or did not disappear at discharge, or the bilirubin levels exceeded 340 μmol/L.Results 1.TB levels were higher than 255 μmol/L in 108 the infants, and in 36 cases of them TB levels were higher than 340 μmol/L. 2.It took 4.0±1.4 days for bilirubin levels to decline to 50 % of initial levels after interruption of nursing. Time for jaundice disappearance was 7.0±2.0 days. In 110 cases followed up, jaundice disappeared rapidly except for 4 cases.Conclusion The most reliable diagnostic evidence of breast-feeding jaundice is jaundice disappearance after temporary discontinuation of breast-feeding without etiologic treatment, but the time for jaundice to vanish varies with individuals.