维汉新生儿小时胆红素百分位曲线图制备及相关因素分析

发布时间：2018-02-23 12:55

本文关键词： 维汉新生儿小时胆红素水平百分位曲线图高危因素　出处：《新疆医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：绘制维吾尔族和汉族健康晚期早产儿及足月儿生后120小时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≥2000g的健康新生儿2131例为研究对象,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χ2检验和多因素Logistic回归分析,找出其相关因素。结果：本研究经皮胆红素峰值出现时间为时龄92～120小时；在同一时龄,P新(40,75,95)均高于国内余章斌等研究P国内,(40,75,95),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),与本研究中汉族新生儿经皮胆红素P维(40,75,95),其中,P国内(40,75,95)高于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病率高于维吾尔族新生儿,χ2=71.523,P0.01,差异有统计学意义；早产、剖宫产、母乳喂养、汉族、开奶时间、胎便排出时间为发生新生儿高胆红素血症的独立危险因素。结论：小时胆红素百分位曲线图反映了生后胆红素水平的变化趋势,对新生儿高胆红素血症具有一定的评估价值；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,高胆红素血症的发病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、胎便排出时间是发生新生儿高胆红素血症的独立危险因素。
[Abstract]:Objective: to draw the percutaneous bilirubin percentile curves within 120 hours after birth of advanced premature infants and full-term infants in Uygur and Han nationality, and to analyze the related influencing factors. To compare the change trend of neonatal bilirubin and the incidence of hyperbilirubinemia in Uygur nationality and Han nationality. Methods: to provide evidence for clinical diagnosis and treatment. Methods: a new type of health was selected from the first affiliated Hospital of Xinjiang Medical University and Urumqi Maternal and Child Health Hospital in December. The gestational age of Uygur and Han nationality was more than 35 weeks and the birth weight was more than 2000g. 2131 newborns were studied. Record in detail the sex, gestational age, mode of delivery, birth weight, feeding method, time of milk opening, time of fecal excretion, premature rupture of membranes, cranial hematoma, which may be related to neonatal jaundice. The transdermal bilirubin value of Minolta type JM-103 was measured twice a day in 3-5 days after birth. The TCB percentile of each newborn was calculated at least 6 times per day, and the TCB percentile of P40 / P75 / P95 / day was calculated, and the curves were plotted. At the same time, the influence of perinatal factors on neonatal hyperbilirubinemia was analyzed by univariate 蠂 2 test and multivariate Logistic regression analysis. At the same time, it was higher than that of Yu Zhangbin in China (P < 0.05). The transdermal bilirubin of Han nationality newborns in this study was higher than that in P country (P = 40755 / 95), and it was higher than that of Chinese neonates (P = 40755 / 95), and it was higher than that of Chinese neonates of Han nationality (P = 40755 / 95), among them, there was no significant difference between the Chinese and the Han nationality in this study. The increase rate of P95 curve is faster than that of P75 and P40 curves. The incidence of hyperbilirubinemia in Han neonates was higher than that in Uygur newborns (蠂 ~ 2 / 71.523 / P0.01), the difference was statistically significant, preterm delivery, cesarean section, breast-feeding, Han nationality, milking time, Fetal stool excretion time is an independent risk factor for neonatal hyperbilirubinemia. Conclusion: the hourly bilirubin percentile curve reflects the trend of postnatal bilirubin level and has certain value in evaluating neonatal hyperbilirubinemia. The level of bilirubin in neonates of Uygur and Han nationality gradually increased with the increase of age, and the rate of increase of bilirubin in newborn infants of Han nationality was higher than that of newborns of Uygur nationality. The incidence of hyperbilirubinemia was also higher than that of Uygur newborns, preterm delivery, cesarean section, breastfeeding, Han nationality, milk opening time and fecal excretion time were independent risk factors of neonatal hyperbilirubinemia.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R722.1

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