新生儿高胆红素血症的远期随访观察

A LONG-TERM FOLLOW-UP OF NEWBORN INFANTS WITH HYPERBILIRUBINEMIA

为探讨新生儿期血清胆红素水平对远期预后的影响 ,对 1 2 6例高胆红素血症患儿在 5～ 8岁时进行智力、听力及神经系统随访检查。结果发现 ,3 3例患儿有程度不等的智力缺陷 ,2 5例有听力损失 ,6例有神经系统的改变。智力、听力及神经系统异常率与血清总红素峰值无显著相关性 (P >0 0 5)。溶血组与非溶血组间异常率无显著性差异 (P >0 0 5)。结果提示 ,除重度高胆红素血症外 ,轻、中度高胆红素血症 (无论是否溶血 )也可对新生儿产生永久性神经损害 ,致精神神经发育异常 ,仅凭血清胆红素水平并不能确切预测远期预后。对所有高胆红素血症新生儿均应积极治疗 ,尽量减少后遗症的发生。

To study the effect of serum bilirubin level on long-term prognosis in neonates with hyperbilirubinemia. 126 babies with hyperbilirubinemia were surveyed. All cases 5-8 years old were examined in intelligence, hearing and nervous system. Results showed that 33 cases had intelligence deficiency at different degree, 25 cases had hearing loss and 6 cases had abnormality in nervous system. There wasn't obvious correlation between abnormal rate in intelligence, hearing and nervous system and the peak value of total bilirubin (P>O. 05). There wasn't significant difference between the abnormal rate of hemolytic group and nonhemolytic group(P>O. 05). Conclusion: mild, moderate, and serere hyperbilirubinemia (whether hemolytic or not) will produce permanent nervous impairment in neonates and cause psychoneurologic abnormality. Long-term prognosis couldn't be exactly prediceted merely depending on the total level of bilirubin. All neonates with hyperbilirubinemia must be actively treated to reduce sequela to the minimum.