兰州地区430例新生儿高胆红素血症的病因及相关因素分析

Analysis of etiology and related factors in 430 cases of neonatal hyperbilirubinemia in Lanzhou area

目的探讨新生儿高胆红素血症(简称高胆)的病因及影响因素。方法对2011年1月至2015年12月期间以新生儿高胆收治入院的430例新生儿的临床资料进行分析。结果感染因素中,肺炎为首位,占33.80%,其次为败血症,占23.47%,非感染因素中,溶血为首位,占24.65%,其次为围产因素,占16.05%。与早产儿组比较,足月儿组就诊日龄较晚,黄疸达峰值日龄较晚,住院时间较短(P<0.05)。与非感染组比较,感染组胎龄小,黄疸出现日龄较晚,黄疸达高峰日龄较晚,黄疸消退速率较慢,住院时间较长(P<0.05)。结论高胆红素血症的主要病因为感染。要做好围产期保健及溶血性疾病的产前筛查,预防感染,完善出院后随访机制,可减少高胆及胆红素脑病的发生。

Objective To explore the etiology and related factors of neonatal hyperbilirubinemla. Methods lhe clinical data in neonates with hyperbilirubinemia were retrospectively analyzed frown January 2011 to December 2015. Results In infection factors, pneumonia was considered as the first cause accounting for 33.80%, followed by sepsis accounting for 23.47%; In the non-infection factors, hemolysis was considered as the first cause accounting for 24.65 %, followed by perinatal factors accounting for 16.05 %. Compared with the preterm infants, the term infants had treatment and jaundice peak at later time and shorter time of hospital stay （ P 〈0.05）. Compared with the noninfection infants, the infection infants had smaller gestational age, later time of jaundice appearance and peak, lower decline rate of jaundice and shorter time of hospital （ P 〈0.05）. Conclusion Infection is a major cause of high blood bilirubin. To do a good job in perinatal care and hemolytic disease of prenatal screening, prevention of infection and improving the system of the follow-up after discharge can reduce high blood bilirubin and bilirubin encephalopathy.