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目的绘制维吾尔族和汉族新生儿生后120 h内经皮胆红素百分位曲线图,分析相关影响因素,比较维吾尔族和汉族新生儿小时胆红素变化趋势及高胆红素血症发生率,为临床诊治提供依据。方法选择2013年2、4、6、8、10、12月在新疆医科大学第一附属医院及乌鲁木齐市妇幼保健院产科出生的维吾尔族及汉族胎龄≥35周且出生体重≥2 000 g的健康新生儿为研究对象,详细记录可能与新生儿黄疸有关的性别、胎龄、分娩方式、出生体重、喂养方式、开奶时间、胎便排出时间、胎膜早破、头颅血肿情况,采用日本美能达JM-103型经皮胆红素测定仪监测其生后3~5天经皮胆红素值(TCB),2次/日,每例新生儿至少有6次测量值,分别计算每一时段的TCB百分位数(P40、P75、P95),并绘制成曲线图,同时将相关围产因素对新生儿高胆红素血症的影响分别进行单因素卡方检验和多因素Logistic回归分析,找出其相关因素。结果本研究共纳入新生儿2 131例,经皮胆红素峰值出现时间为时龄92~120 h;在同一时龄,本研究中汉族新生儿经皮胆红素P汉(40,75,95)均高于P国内(40,75,95)与本研究中维吾尔族新生儿P维(40,75,95);P95曲线上升速度快于P75和P40曲线;汉族新生儿高胆红素血症发生率高于维吾尔族新生儿(χ2=71.523,P<0.01);早产(OR=3.775)、剖宫产(OR=9.176)、母乳喂养(OR=2.942)、汉族(OR=4.090)、开奶时间>24 h(OR=1.622)、胎便排出时间>24 h(OR=1.445)为发生新生儿高胆红素血症的独立危险因素。结论维吾尔族和汉族新生儿胆红素水平随着日龄的增长逐渐升高,其中汉族新生儿生后小时胆红素水平上升速率较维吾尔族新生儿高,高胆红素血症的发生率亦高于维吾尔族新生儿;早产、剖宫产、母乳喂养、汉族、开奶时间晚、胎便排出时间晚是发生新生儿高胆红素血症的独立危险因素。
Objective To draw the percutaneous bilirubin percentage curve of newborn infants from Uygur and Han nationality within 120 hours after birth and analyze the related factors and compare the changes of hourly bilirubin and the incidence of hyperbilirubinemia in Uygur and Han nationality neonates , Provide the basis for clinical diagnosis and treatment. Methods Two-year-old Uyghur and Han children born at the First Affiliated Hospital of Xinjiang Medical University and Maternal and Child Health Hospital of Xinjiang Uygur Autonomous Region at February, April, June, August, October and December 2013 were enrolled. Healthy newborns as the object of study, detailed records may be related to neonatal jaundice-related sex, gestational age, mode of delivery, birth weight, feeding methods, open milk time, meconium discharge time, premature rupture of membranes, The transdermal bilirubin value (TCB) of 3 to 5 days after birth was measured by JM-103 transdermal bilirubin meter, and twice in every day. Each newborn had at least 6 measurements, each of which was calculated (P40, P75, P95) were plotted and plotted. The effects of perinatal factors on neonatal hyperbilirubinemia were analyzed by one-way chi-square test and multivariate logistic regression respectively Analysis, find out the relevant factors. Results A total of 2113 newborns were included in this study. The peak time of transcutaneous bilirubin peak was 92-120 h. In the same age group, transdermal bilirubin P Han (40,75, 95) were higher than those in P (40,75,95) and P dimension (40,75,95) of neonates in this study. P95 curve was faster than P75 and P40 curves; Han neonatal hyperbilirubin Preterm birth (OR = 3.775), cesarean section (OR = 9.176), breastfeeding (OR = 2.942), Han nationality (OR = 4.090) were higher than those of Uighur newborn (χ2 = 71.523, , Open milk time> 24 h (OR = 1.622), meconium discharge time> 24 h (OR = 1.445) was an independent risk factor for neonatal hyperbilirubinemia. Conclusions The bilirubin level of neonates in Uygur and Han nationality increased gradually with the increase of age. The increase rate of bilirubin level in neonates after birth was higher than that in Uygur nationality, and the incidence of hyperbilirubinemia Also higher than the Uygur newborn; premature delivery, cesarean section, breastfeeding, Han nationality, late opening of milk, meconium discharge late is neonatal hyperbilirubinemia independent risk factors.