新生儿高胆红素血症危险因素分析及预防措施探讨

Risk factors for neonatal hyperbilirubinemia and related preventive measures

目的:分析新生儿高胆红素血症(NHB)危险因素,探讨其预防措施。方法:选取2016年2月至2018年5月我院新生儿科200例住院患儿为研究对象,回顾性分析患儿的临床资料,根据是否患有高胆红素血症分为A组(高胆红素患儿组)和B组(未患高胆红素血症的患儿组),其中A组120人,B组80人。使用χ2检验进行NHB的单因素分析,使用多因素Logistic回归分析NHB的危险因素,并根据其相关因素提出针对性预防措施。结果:早产、过期妊娠、产程延长、低体重、剖宫产、羊水粪染、宫内窘迫、人工喂养、母亲妊娠高血压、母亲妊娠糖尿病、母亲妊娠期间使用抗生素、子母血型不合等12个因素是NHB的密切相关危险因素;其中早产、产程延长、低体重、羊水粪染、宫内窘迫、人工喂养、母亲妊娠高血压、母亲妊娠糖尿病、子母血型不合均是NHB的高度相关危险因素,数据差异具有统计学意义(P<0.05)。结论:早产、产程延长、低体重、羊水粪染、宫内窘迫、人工喂养、母亲妊娠高血压、母亲妊娠糖尿病、子母血型不合等9个因素是NHB的高度相关危险因素;规范进行一系列的产前检查,及时对孕期相关危险因素进行干预,提高助娩水平,科学喂养新生儿,可降低NHB的发生率。

Objective: To investigate the risk factors for neonatal hyperbilirubinemia(NHB) and related preventive measures. Methods: A total of 200 infants who were hospitalized in Department of Neonatology in our hospital from February 2016 to May 2018 were enrolled, and a retrospective analysis was performed for their clinical data. According to the presence or absence of hyperbilirubinemia, the infants were divided into group A(120 infants with NHB) and group B(80 infants without NHB). The chi-square test was used for univariate analysis of NHB, a multivariate logistic regression analysis was used to investigate the risk factors for NHB, and targeted preventive measures were developed based on such factors. Results: A total of 12 risk factors were closely associated with NHB, i.e., preterm birth, prolonged pregnancy, prolonged labor, low birth weight, cesarean section, amniotic fluid turbidity, intrauterine distress, artificial feeding, maternal pregnancy-induced hypertension, maternal gestational diabetes, use of antibiotics in mother during pregnancy, and maternal-fetal blood group incompatibility. Among these factors, preterm birth, prolonged labor, low birth weight, amniotic fluid turbidity, intrauterine distress, artificial feeding, maternal pregnancy-induced hypertension, maternal gestational diabetes, and maternal-fetal blood group incompatibility were highly associated with NHB(P < 0.05). Conclusion: The nine risk factors of preterm birth, prolonged labor,low birth weight, amniotic fluid turbidity, intrauterine distress, artificial feeding, maternal pregnancy-induced hypertension, maternal gestational diabetes, and maternal-fetal blood group incompatibility are highly associated with NHB. The incidence rate of NHB can be reduced by standardization of prenatal examination, timely intervention of related risk factors during pregnancy, an improvement in assisted delivery, and scientific feeding of neonates.