早产儿光疗后遮光部位经皮胆红素值与血清总胆红素值相关性研究

Correlation of transcutaneous bilirubin level of shielded skin and total serum bilirubin level after phototherapy in premature infants

目的探讨早产儿光疗后遮光部位经皮胆红素(transcutaneous bilirubin measurements,TcB)值与血清总胆红素(total serum bilirubin,TSB)值的相关性。方法选择2019年7月至2021年7月温州医科大学附属乐清医院新生儿科收治的黄疸且需要光疗的早产儿进行前瞻性研究,根据胎龄分为26~31周组、32~34周组和35~36周组。光疗时在前额部、前胸部、会阴部TcB检测区域用遮光材料覆盖,光疗前后测定前额部、前胸部、会阴部TcB各3次并取平均值,同时取静脉血检测TSB。应用SPSS 24.0统计软件分析不同胎龄早产儿不同部位TcB值与TSB值的相关性。结果共纳入306例早产儿,26~31周组51例、32~34周组126例、35~36周组129例。光疗前所有患儿前额部、前胸部、会阴部TcB值与TSB值均相关(r=0.699、0.913、0.734,P均<0.001),其中前胸部TcB值与TSB值相关性最好,因此采用早产儿光疗前TSB值与前胸部TcB值建立直线回归方程:TSB=0.634+0.912TcB。光疗后,所有患儿的前额部、前胸部、会阴部TcB值与TSB值也相关(r=0.586、0.879、0.690,P均<0.001),其中前胸部TcB值与TSB值相关性最好,因此采用早产儿光疗后TSB值与前胸部TcB值建立直线回归方程:TSB=1.910+0.736TcB。结论胎龄26~36周早产儿黄疸光疗后前胸部遮盖区域TcB值与TSB值相关性好,可以建立直线回归模型。

Objective To study the correlation between transcutaneous bilirubin(TcB)level measured from shielded skin and total serum bilirubin(TSB)level after phototherapy in premature infants.Methods From July 2019 to July 2021,preterm infants with jaundice admitted to the Department of Neonatology of our hospital and received phototherapy were prospectively enrolled in the study.The infants were assigned into 26~31w group,32~34w group and 35~36w group according to their gestational ages.During phototherapy,the forehead,the chest and the perineum were shielded.TcBs were measured at the above mentioned areas three times each before and after phototherapy and TSB was measured from venous blood samples.Results A total of 306 premature infants were included,with 51 cases in 26~31w group,126 cases in 32~34w group and 129 cases in 35~36w group.Before phototherapy,TcBs of the forehead,the chest and the perineum of all infants were correlated with TSB(r=0.699,0.913,0.734,P<0.001)with TcB of the chest showed the best correlation.A linear regression equation was established using the TSB before phototherapy and the TcB of the chest:TSB=0.634+0.912TcB.After phototherapy,TcBs of the forehead,the chest and the perineum of all infants were also correlated with TSB(r=0.586,0.879,0.690,P<0.001)with TcB of the chest showed the best correlation and the linear regression equation was TSB=1.910+0.736TcB.Conclusions For preterm infants with gestational age of 26~36w,TcB of the shielded chest skin after phototherapy is correlated with TSB and a linear regression model can be established.