高胆红素血症新生儿情绪与行为的研究

Emotional and behavioral changes in hyperbilirubinemia newborn

目的对高胆红素血症新生儿进行测评,探讨高胆红素血症对新生儿情绪及行为的影响。方法随机选取2010年5月—2013年10月杭州师范大学附属医院诊治的87例高未结合胆红素血症新生儿,分为高胆1组和高胆2组,在黄疸消退后采用NBNA评分法、5分钟眨眼试验、吸吮阻断试验进行测评,72例同日龄正常新生儿为对照组。结果 1高胆1组和高胆2组黄疸期患儿NBNA总分36.24±1.50和33.95±1.70,明显低于正常组,高胆1和2组不易安抚的患儿为31.11%(14/45)和50.00%(21/42),均高于正常组,且自发性眨眼明显增多(P<0.05);2高胆红素血症新生儿在黄疸消退后,NBNA评分和自发性眨眼频率较黄疸高峰期有所恢复,结果差异有统计学意义(P<0.05)。3黄疸消退后高胆2组NBNA总分包括原始反射、一般评估仍明显低于正常同日龄新生儿(P<0.05);吸吮阻断后较同龄新生儿难以抚慰((P<0.05);自发性眨眼频率仍较同日龄新生儿增多(P<0.05)。4黄疸消退后高胆1组的NBNA评分、吸吮阻断后的抚慰性、自发性眨眼恢复较好,与高胆2组比较,P<0.05。结论高胆红素血症可影响新生儿的行为表现和情绪反应,其影响程度与黄疸严重度有关,而程度重者则不能完全恢复正常,对今后的认知、学习、情绪、智力等方面将会造成一定的影响。

Objective To evaluate the high blood bilirubin newborns, and to explore the effects of hyperbilirubinemia on emotion and behavior of newborns. Methods 87 unconjugated hyperbilirubinemia newborns were selected randomly in our hospital from May 2010 to October 2013 ,they were divided into high bile group Ⅰ （45 cases） and group Ⅱ （42 ca- ses）. NBNA score,5 minute blink eye test and sucking blocking test were evaluated before and after the jaundice subsi- ded. 72 normal newborns were set as the control group. Results ①The NBNA score of high cholesterol 1 group and 2 group were 36.24 ± 1.50 and 1.50 ± 1.70, which were lower than that of normal group, not easy to reassure children were 31.11% （14/45） and 50.00% （21/42）, higher than that of the normal group, and eyeblinking rate was increased （P 〈 0.05 ）. ② After the jaundice faded, NBNA scores ,5 minutes eyeblinking test and sucking interrupt test of the hyperbiliru- binemia newborns improved significantly（ P 〈 0.05 ）. ③After the jaundice faded, NBNA scores, especially the primary re- flex and general assessment of the hyperbilirnbinemia group Ⅱ were obviously lower than those of the normal group （ P 〈 0.05 ）. They still showed more difficult pacified behavior in the sucking interrupting test and higher spontoneous eyeblink- ing rate than that of the normal group（ P 〈 0.05 ）. ④Mter the jaundice faded, NBNA, sucking interrupting test and spon- taneous eyeblink test of the hyperbilirubinemia group I were much better than those of the group Ⅱ （ P 〈 0.05 ）. Conclu- sion Hyperbilirnbinemia may have negative effects on emotion and behavior in newborns, which was related with the effect degree and severity of jaundice. The degree of the person that weigh was not completely back to normal, which will cause certain effect for the future of cognition, learning, emotional intelligence and so on.