新生儿高胆红素血症相关影响因素分析

A study on clinical related factors in neonatal hyperbilirubinemia

目的探讨新生儿高胆红素血症的相关影响因素,为临床预防及治疗新生儿高胆红素血症治疗提供理论依据。方法对2011年1月—2012年1月新疆医科大学第一附属医院5 023例新生儿(产科新生儿4 442例及新生儿科高胆红素血症病例581例)临床资料进行回顾性及描述性分析,采用Logistic回归分析其影响因素。结果(1)单因素分析显示:民族、胎龄、出生体质量、胎膜早破、头颅血肿、喂养方式、缺氧、产前抗生素应用、母子血型不合、开奶时间、胎便排出时间、同胞中有高胆红素血症12项为影响因素。(2)Logistic回归分析显示:缺氧、产前抗生素使用、胎便排出时间差异无统计学意义(P>0.05);民族、胎龄、出生体质量为新生儿高胆红素血症保护性因素;胎膜早破、头颅血肿、喂养方式、母子血型不合、开奶时间、同胞中有高胆红素血症为新生儿高胆红素血症危险因素(P<0.05)。(3)多元Logistic回归分析显示:胎龄和出生体质量为新生儿高胆红素血症保护性因素(P<0.05),母子血型不合、开奶时间、同胞中高胆红素血症、胎膜早破为其病情严重程度的危险因素(P<0.05)。结论新生儿高胆红素血症与多种相关因素有关,应根据相关危险因素制定诊治方案,积极预防感染,重视产前相关检查及产后胆红素监测,降低高胆红素血症发病率,减少高胆红素血症对新生儿生长发育的影响。

Objective The study is to investigate the related factors in neonatal hyperbilirubinemia,and to provide clinical evidence for clinical prevention and treatment of neonatal hyperbilirubinemia.Methods 5 023 cases neonatal （normal newborn of 4442 cases and 581 cases of hyperbilirubinemia ）from Depart-ment of Obstetrics and neonatology in The First Affiliated Hospital of Xinjiang Medical University from January 2011 to January 2012 were retrospectively reviewed and the related factors were analyzed by using Logistic regression.Results （1 ）Single factor analysis of the related factors showed that the related factors included ethnicity,gestational age,birth weight,premature rupture of membranes,cephalhematoma,way of feeding,hypoxia,antibiotics,prenatal mother and child blood group incompatibility,open milk time,meconium discharge time,compatriots in neonatal hyperbilirubinemia.（2）Logistic regression analysis of the related factors showed that ethnicity,gestational age,birth weight are the protective factors （P 〈0.05）,while premature rupture of membranes,cephalhematoma,method of feeding,mother and child blood group incompatibility,open milk time,compatriots in neonatal hyperbilirubinemia are the＆amp;nbsp;risk factors （P 〈0.05）.（3）Multivariate logistic analysis showed that gestational age and birth weight are protective factors in the neonatal hyperbilirubinemia （P 〈0.05）,while mother and child blood group incompatibility,open milk time,hyperbilirubinemia compatriots and premature rupture of membranes are the risk factors （P 〈0.05）.Conclusion There are a variety of related factors in neonatal hyperbilirubi-nemia.We should decide proper treatments with regard to the related risk factors and prevent infection, put emphasis on prenatal inspection and after-birth bilirubin monitoring in order to reduce the incidence of hyperbilirubinemia,particularly the incidence of severe of hyperbilirubinemia,and the impact of hyperbil-irubinemia on neonatal growth and development.