早产儿不同部位经皮胆红素监测结果准确性的meta分析

The accuracy of percutaneous bilirubin monitoring results in different parts of premature infants:a meta-analysis

目的探讨早产儿不同部位经皮胆红素(TCB)监测结果的准确性,为早产儿的黄疸监测提供循证参考依据。方法通过计算机检索PubMed、Cochrane Library、Embase、中国知网(CNKI)、中国生物医学文献服务系统(CBM)、维普资讯中文期刊服务平台(VIP)、万方医学网等数据库,搜集早产儿不同部位TCB测定值与血清总胆红素(TSB)值相关性的文献,检索时限为建库至2020年9月30日。由2名研究者采用QUADAS-2量表对纳入文献质量进行评价,将Pearson相关系数进行Fisher′Z转化后并进行meta分析。结果最终纳入18篇文献,共1806例样本。早产儿前额、胸骨部、腹部、肩胛部TCB监测结果与同时间TSB值的相关性均较好(r=0.814、0.824、0.735、0.862,95%可信区间:0.77~0.85、0.76~0.87、0.61~0.83、0.85~0.87)。结论早产儿不同部位TCB测定值与同时间TSB值的相关性均较好,不同部位TCB监测结果的准确性依次为肩胛部、胸骨部、前额、腹部。建议在进行早产儿TCB监测时首选肩胛部作为检测部位。

Objective To investigate the accuracy of transcutaneous bilirubin(TCB)monitoring results at different parts in premature infants,and to provide evidence-based reference for the monitoring of jaundice in premature infants.Methods The databases of PubMed,Cochrane Library,Embase,China national knowledge infrastructure(CNKI),Chinese BioMedical Literature Database(CBM),VIP and Wanfang databases were searched to collect literatures on the correlation between the TCB and the Total Serum Bilirubin(TSB)of different parts of premature infants from inception to September 30,2020.The quality of the included literatures were evaluated by two evaluators according to the Quality Assessment of Diagnostic Accuracy Studies(QUADAS-2)scale,and then Pearson correlation coefficient was transformed into Fisher′Z and meta-analysis was performed.Results A total of 18 literatures were included,including 1,806 samples.The results of TCB monitoring in the forehead,sternum,abdomen and scapula of premature infants were well correlated with TSB at the same time(r=0.814,0.824,0.735,0.862;95%CI:0.77-0.85,0.76-0.87,0.61-0.83,0.85-0.87).Conclusion There was a good correlation between the measured TCB values of different parts in premature infants and the TSB values at the same time.The accuracy of the monitoring results of different parts of TCB was as follows:scapula,sternum,forehead and abdomen.It is suggested that the scapular skin should be the first choice for preterm TCB monitoring.