新生儿黄疸光疗后反弹因素分析及管理初探

Analysis and management of rebound factors of neonatal jaundice after phototherapy

目的探讨新生儿黄疸光疗后反弹的影响因素,提出管理对策。方法收集2013年1月至2016年12月在南宁市第四人民医院住院治疗的242例黄疸患儿,按光疗结果分为反弹组和无反弹组,分析两组患儿的临床资料和实验室检测资料,对单因素分析中差异有统计学意义的因素纳入多元Logistic分析。结果 36例光疗后反弹,反弹率为14.88%;单因素分析结果显示,新生儿黄疸光疗后反弹与胎龄短、产式为剖宫产、胎儿窘迫、羊水少及新生儿ABO溶血病有关(P<0.05);经多元Logistic分析发现,新生儿ABO溶血病及产式为剖宫产是新生儿黄疸光疗后反弹的影响因素(P<0.05)。结论新生儿黄疸光疗后反弹率较高与新生儿ABO溶血病和产式为剖宫产有关,应加强管理,根据上述因素进行干预,改善新生儿结局。

Objective To explore the factors influencing the rebound of neonatal jaundice after phototherapy,and put forward management countermeasures. Methods From January 2013 to December 2016, 242 children with jaundice treated in the Nanning Fourth People’s Hospital were divided into rebound group and non-rebound group according to the results of phototherapy. The clinical data of the two groups were analyzed, and the factors with statistical difference in univariate analysis were included in the multivariate Logistic analysis. Results Among the 242 children,36 had rebound after phototherapy, and the rebound rate was 14.88%. Univariate analysis showed that the rebound of neonatal jaundice after phototherapy was related to short gestational age, cesarean section, fetal distress, oligohydramnios, and neonatal ABO hemolysis(P<0.05). Multiple Logistic analysis showed that neonatal ABO hemolytic disease and cesarean section were related factors of rebound after phototherapy of neonatal jaundice(P<0.05). Conclusion The rebound rate of neonatal jaundice after phototherapy was higher, which was related to neonatal ABO hemolysis disease and cesarean section. Therefore, the management should be strengthened, and intervention should be carried out according to the above factors to improve the neonatal outcome.