新生儿皮肤遮盖与暴露部位经皮胆红素测量值与血清总胆红素值的对比研究

发布时间：2019-05-09 18:34

【摘要】：目的分析新生儿光照疗法中皮肤遮盖部位与暴露部位经皮胆红素测量值与血清总胆红素值的相关性,为临床在光照疗法中选择经皮胆红素测量部位提供参考依据。方法选取2016年1月29日—4月15日收治的112例高间接胆红素血症患儿作为研究对象。选取临床常用的两个皮肤暴露部位及两个遮盖部位作为经皮胆红素的测量部位。在入院时及光照疗法过程中采血监测血清总胆红素值,同时测定暴露部位与遮盖部位的经皮胆红素值。结果在光照疗法中的4个时间点,2个暴露部位的经皮胆红素测量值与血清总胆红素值相比,差异均具有统计学意义(均P0.01)。遮盖部位中,遮盖的胸骨第二肋正中处皮肤的4次经皮胆红素测量值与血清总胆红素值相比,差异均无统计学意义(均P0.05)。当血清总胆红素大于307.8μmol/L(18 mg/dl)时,血清总胆红素值均高于经皮胆红素测量值,差异均具有统计学意义(均P0.01)。结论光照疗法中选择皮肤遮盖部位,尤以选择遮盖的胸骨第二肋正中皮肤测量的经皮胆红素值能更准确反映血清总胆红素水平。当血清总胆红素值大于307.8μmol/L(18 mg/dl)时,经皮胆红素测量值不能准确反映血清总胆红素水平。
[Abstract]:Objective to analyze the correlation between the measured values of percutaneous bilirubin in skin covering and exposed parts of newborn infants and the serum total bilirubin level in order to provide a reference for clinical selection of the location of percutaneous bilirubin measurement in light therapy. Methods 112 children with hyperbilirubinemia were selected from January 29 to April 15, 2016. Two skin exposed sites and two covering sites were selected as the measuring sites of percutaneous bilirubin. Blood samples were collected at admission and during light therapy to monitor the value of serum total cholin, and the value of transcortical cholin in the exposed site and the covering site was measured at the same time. at the same time, the serum total cholin value was measured at the time of admission and during light therapy. Results at 4 time points in light therapy, there was significant difference between the measured values of transcutaneous bilirubin in the two exposed sites and the total serum cholin value (all P 0.01). The results showed that there was significant difference between the two exposed sites and the serum total cholin value at 4 time points in light therapy (all P 0.01). In the covering part, there was no significant difference between the skin of the middle part of the second rib of the covered sternum and the total serum cholinoid (P0.05). 4 times of percutaneous bilirubin measurement in the middle of the second rib of the covered sternum was not significantly different from the total serum cholinergic value (P0.05). When the serum total bilirubin was higher than 307.8 渭 mol / L (18 mg/dl), the serum total bilirubin level was significantly higher than that measured by percutaneous bilirubin (P0.01). Conclusion selection of skin covering site in light therapy, especially in the middle skin of the second rib of covered sternum, can reflect the level of serum total bilirubin more accurately. When the serum total cholin value was more than 307.8 渭 mol / L (18 mg/dl), the measured value of transdermal bilirubin could not accurately reflect the serum total bilirubin level.
【作者单位】：四川大学华西第二医院新生儿科/出生缺陷与相关妇儿疾病教育部重点实验室;四川大学华西第二医院病案管理科;
【基金】：四川省卫生和计划生育委员会2016年度立项科研课题(16PJ250)
【分类号】：R722.1

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