安徽省淮南地区正常足月新生儿生后7日内胆红素的动态检测

发布时间：2018-05-29 08:36

  本文选题：足月新生儿 + 胆红素　； 参考：《安徽医科大学》2012年硕士论文

【摘要】：目的：通过动态检测正常足月新生儿血清总胆红素（total serum bilirubin TSB），确定淮南市地区正常足月新生儿生后7天内血清总胆红素变化范围，为新生儿黄疸干预提供理论根据。 方法：(1)对1257例符合纳入标准的正常足月新生儿用微量法测定生后第1～7天血清总胆红素值，计算各时间点第25，50，75，95百分位值、观察其高峰值（peakserum bilirubin PSB)以及高峰出现时间，，并同步以经皮法测定其胆红素值。(2)随机抽取50例新生儿血清标本,用生化法测定血清总胆红素值,并同步以微量法和经皮法测定胆红素值，分别计算经皮胆红素值（transcutaneous bilirubin TcB）与静脉血总胆红素值、末梢微量血胆红素值与静脉血总胆红素值之间的相关系数、检验其统计学意义，并得出直线回归方程；（3）根据所有新生儿经皮胆红素、末梢微量血胆红素两者的同步值，经统计学处理，进行方法学比较；（4）统计入选50例新生儿不同皮肤黄染范围相对应的静脉血总胆红素值，得出不同皮肤黄染范围相对应的胆红素估计值； 结果：1）1257例该地区正常足月新生儿生后第1～7天血清胆红素值的第25、50、75、95百分位值是第1天58.64μmol/L,72.51μmol/L,102.44μmol/L,120.35μmol/L,第2天105.41μmol/L,119.72μmol/L,150.18μmol/L,185.30μmol/L，第3天128.85μmol/L,157.95μmol/L,191.22μmol/L,227.61μmol/L，第4天为160.24μmol/L,191.40μmol/L,216.65μmol/L,277.49μmol/L，第5天164.26μmol/L,179.51μmol/L,209.88μmol/L,263.74μmol/L，第6天131.87μmol/L,172.73μmol/L,195.57μmol/L,231.26μmol/L，第7天118.94μmol/L,157.57μmol/L,204.83μmol/L,223.84μmol/L。PSB为294.46μmol/L，高峰出现在第4天；（2）微量法、经皮法均与生化法有良好的相关性(微量法与生化法r=0.948，t=21.067；经皮法与生化法r=0.935，t=18.333)；（3）微量法、经皮法对正常足月新生儿的胆红素进行测定,1～3d和6～7d胆红素测定值两法比较,差异有统计学意义(P＜0.05),第4～5天比较差异无统计学意义(P＞0.05)；（4）皮肤黄染在头面部其血清总胆红素值为112.3±6.2μmol/L，到胸部为165.1±26.7μmol/L，到腹部为214.0±30.8μmol/L，到膝、肘为268.5±28.2μmol/L，到手、足心为＞271.7μmol/L。 结论：本研究得出了安徽省淮南市地区地区正常足月新生儿生后1～7d血清总胆红素的变化范围、高峰值以及高峰出现时间,为本地区足月新生儿黄疸的合理干预提供依据；以微量法监测新生儿血清胆红素,结果准确可靠；通过目测皮肤黄染范围，初步估计其胆红素值，不失为一种简便易行的方法。
[Abstract]:Objective: to determine the range of changes of serum total bilirubin in normal full-term newborns within 7 days after birth by dynamic detection of total bilirubin in normal term neonates, and to provide theoretical basis for the intervention of neonatal jaundice. Methods Total serum bilirubin was measured in 1257 normal full-term newborns by microanalysis on the 1st day after birth. The total bilirubin was calculated at 25 ~ 50 ~ 75 ~ (95) percentile at each time point, and the peak value (peakserum bilirubin) and the time of peak appearance were observed. The serum bilirubin of 50 newborns was measured by biochemical method, and bilirubin was measured by microanalysis and transcutaneous method simultaneously, and the serum bilirubin value was measured by microanalysis and transcutaneous method simultaneously, and the serum bilirubin was measured by biochemical method, and the serum bilirubin value was measured by transcutaneous method. The correlation coefficient between transcutaneous bilirubin and total bilirubin in venous blood, trace bilirubin in peripheral blood and total bilirubin in venous blood were calculated, respectively. According to the simultaneous values of transcutaneous bilirubin and microbilirubin in peripheral blood of all neonates, the linear regression equation was obtained. The total bilirubin values of venous blood of 50 newborns with different skin yellow staining ranges were selected and the corresponding bilirubin estimates of different skin yellow staining ranges were obtained. 缁撴灉:1)1257渚嬭�ュ湴鍖烘�ｅ父瓒虫湀鏂扮敓鍎跨敓鍚庣��1~7澶╄��娓呰儐绾㈢礌鍊肩殑绗

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