来宾地区990例新生儿高胆红素血症的病因及诊治分析

Analysis of etiology,diagnosis and treatment of 990 cases of neonatal hyperbilirubinemia in Laibin area

目的分析来宾地区新生儿高胆红素血症的临床特点及病因,为提高临床医师对新生儿高胆红素血症的诊治水平提供帮助。方法选取医院2015年12月-2017年12月在新生儿科住院并确诊为新生儿高胆红素血症患儿990例为研究对象,分析其病因、治疗及转归。结果新生儿高胆红素血症病因第一位为围生期因素(464例,占46. 87%),第二位为感染性因素(203例,占20. 51%),第三位为葡萄糖-6-磷酸脱氢酶(G6PD)缺乏(132例,占13. 33%),第四位为母乳性黄疸(108例,占10. 91%),第五位为ABO血型不合溶血(72例,占7. 27%)。经治疗后,治愈863例,好转75例,转诊46例,放弃治疗6例。结论新生儿高胆红素血症的病因较为复杂,发病率高,其中围生期因素、感染因素、G6PD缺乏是最重要的致病因素。加强围生期保健、预防感染,对黄疸出现早、进展快、病情重的患儿积极完善G6PD酶及新生儿溶血病三项试验筛查,尽早干预,可降低高胆红素血症的发病率,预防胆红素脑病。

Objective To investigate the clinical characteristics and etiology of neonatal neonatal hyperbilirubinemia in Laibin area, so as to provide help for clinicians to improve the diagnosis and treatment of neonatal hyperbilirubinemia. Methods 990 cases of neonatal hyperbilirubinemia in the hospital in neonatology from December 2015 to December 2017 were selected as the research subjects, and the etiology, treatment and prognosis were analyzed. Results The cause of the region for the first neonatal hyperbilirubinemia was perinatal factors （ 464 cases, 46. 87% ）, second for infectious factors （ 203 cases, 20.51% ）, third for glucose-6-phosphate debydrogenase （G6PD） deficiency （ 132 cases, 13.33 % ）, fourth for breast milk jaun- dice （ 108 cases, 10.91% ）, fifth for ABO hemolytic （72 cases,7.27% ）. After treatment, 863 cases were cured, 75 cases were improved,46 cases were referral and 6 cases were given up. Conclusion The etiology of neonatal hyperbilirubinemia is complex and the incidence is high. Perinatal factors,infection factors and G6PD deficiency are the important causes of neonatal hyperbilirubinemia. Strengthening perinatal health care, reduce the chances of infection,the early jaundice, rapid progression and the severity of children to actively improve the G6PD enzyme and three trials of neonatal hemolytic disease screening, early intervention, can reduce the incidence of hyperbilirubinemia and prevent bilirubin encephalopathy.