Audit of Neonatal Jaundice as Experienced at a Mission Hospital in Western Nigeria

Introduction: Neonatal jaundice (NNJ) is a common disorder in neonates that can impact negatively on the brain and cause death. The peculiarities in aetiology and solutions for different settings are a knowledge gap. This informed the desire to determine local aetiology and solutions for neonatal jaundice in a missionary hospital in Abeokuta, Southwestern Nigeria. Methods: Consecutive consenting babies diagnosed with significant neonatal jaundice were studied between July 2016 and June 2019. Institutional ethical consent was obtained. A proforma was used to obtain socio-demographic data and other relevant information such as age, sex, birthweight, gestational age and history regarding the jaundice. All the information obtained was inputted into a computer and analysed with SPSS version 16. Results: A total of 179 babies with neonatal jaundice comprising of 120 (67.0%) boys and 59 (33.0%) girls with ages ranging between 1 and 12 days (mean 2.7 ± 2.9) were studied. Prematurity, ABO incompatibility, neonatal sepsis and glucose-6-phosphate enzyme deficiency accounted for over 80% of the causes of significant NNJ. Sixty (33.5%) of the 179 babies studied developed acute bilirubin encephalopathy and 11 (6.1%) mortalities were recorded. Higher proportions of babies that were out-born with spontaneous vaginal delivery modes had acute bilirubin encephalopathy (p < 0.05). Mothers with formal education had better outcome compared to mothers without, in terms of mortalities (p < 0.05). Conclusion: Neonatal jaundice is still a significant cause of morbidity and mortality in the neonatal age group. Maternal education is key to good outcome in neonatal jaundice.

喂养方式与新生儿高胆红素血症的相关性研究及护理对策

目的 探讨喂养方式对新生儿高胆红素血症的影响。方法 采用ＳＤＳ对２０６例产妇产后１周内的新生儿高胆红素血症发生情况进行调查分析，分为纯母乳喂养组及混合喂养组。结果 纯母乳喂养组的高胆红素血症发生率高于混合喂养组，混合喂养组的新生儿高胆红素血症恢复情况明显好于纯母乳喂养组。提示 产妇产后泌乳量不足时，适当添加辅食，待母乳足量时再行纯母乳喂养，可降低新生儿高胆红素血症发生率。

大泡性脂肪变性对活体肝移植右半肝供者早期预后的影响

目的研究轻度大泡性脂肪变性对活体肝移植供者右半肝切除术后早期肝功能恢复及再生的影响。方法回顾性分析2007年10月至2009年5月间本移植外科小组完成的95例活体肝移植术（living donor liver transplantation LDLT）供者的临床资料。术中冰冻活检发现15例存在轻度大泡性脂肪变性（20％～30％5例，10％～19％10例）（A组），80例无明显脂肪变性（B组）。比较两组术前基本资料及术后临床结果。结果单因素分析发现A、B两组术前平均年龄、性别比、残肝体积比、保留肝中静脉／X〈保留肝中静脉比无显著差异（P=0．870，P=0．608，P=0．928，P=0．196），但A组体重指数（BMI）显著高于B组（P=0．013）。f检验发现A组术后总胆红素（TBIL）、丙氨酸氨基转移酶（ALT）峰值显著高于B组（P=0．001，P=0．039），2组术后半月的肝脏再生率无显著差异（P=0．939）；Logistic多因素统计分析发现轻度大泡性脂肪变性是导致供者术后高胆红素血症的危险因素（OR=5．375，95％可信区间1．467—19．696，P=0．011）。结论轻度大泡性脂肪变性是术后高胆红素血症的独立危险因素，从供者安全性考虑，对活体肝移植供者需仔细进行术前评估。