新生儿黄疸光疗后反弹因素分析及管理初探
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摘要
目的探讨新生儿黄疸光疗后反弹的影响因素,提出管理对策。方法收集2013年1月至2016年12月在南宁市第四人民医院住院治疗的242例黄疸患儿,按光疗结果分为反弹组和无反弹组,分析两组患儿的临床资料和实验室检测资料,对单因素分析中差异有统计学意义的因素纳入多元Logistic分析。结果 36例光疗后反弹,反弹率为14.88%;单因素分析结果显示,新生儿黄疸光疗后反弹与胎龄短、产式为剖宫产、胎儿窘迫、羊水少及新生儿ABO溶血病有关(P<0.05);经多元Logistic分析发现,新生儿ABO溶血病及产式为剖宫产是新生儿黄疸光疗后反弹的影响因素(P<0.05)。结论新生儿黄疸光疗后反弹率较高与新生儿ABO溶血病和产式为剖宫产有关,应加强管理,根据上述因素进行干预,改善新生儿结局。
Objective To explore the factors influencing the rebound of neonatal jaundice after phototherapy,and put forward management countermeasures. Methods From January 2013 to December 2016, 242 children with jaundice treated in the Nanning Fourth People's Hospital were divided into rebound group and non-rebound group according to the results of phototherapy. The clinical data of the two groups were analyzed, and the factors with statistical difference in univariate analysis were included in the multivariate Logistic analysis. Results Among the 242 children,36 had rebound after phototherapy, and the rebound rate was 14.88%. Univariate analysis showed that the rebound of neonatal jaundice after phototherapy was related to short gestational age, cesarean section, fetal distress, oligohydramnios, and neonatal ABO hemolysis(P<0.05). Multiple Logistic analysis showed that neonatal ABO hemolytic disease and cesarean section were related factors of rebound after phototherapy of neonatal jaundice(P<0.05). Conclusion The rebound rate of neonatal jaundice after phototherapy was higher, which was related to neonatal ABO hemolysis disease and cesarean section. Therefore, the management should be strengthened, and intervention should be carried out according to the above factors to improve the neonatal outcome.
Objective To explore the factors influencing the rebound of neonatal jaundice after phototherapy,and put forward management countermeasures. Methods From January 2013 to December 2016, 242 children with jaundice treated in the Nanning Fourth People's Hospital were divided into rebound group and non-rebound group according to the results of phototherapy. The clinical data of the two groups were analyzed, and the factors with statistical difference in univariate analysis were included in the multivariate Logistic analysis. Results Among the 242 children,36 had rebound after phototherapy, and the rebound rate was 14.88%. Univariate analysis showed that the rebound of neonatal jaundice after phototherapy was related to short gestational age, cesarean section, fetal distress, oligohydramnios, and neonatal ABO hemolysis(P<0.05). Multiple Logistic analysis showed that neonatal ABO hemolytic disease and cesarean section were related factors of rebound after phototherapy of neonatal jaundice(P<0.05). Conclusion The rebound rate of neonatal jaundice after phototherapy was higher, which was related to neonatal ABO hemolysis disease and cesarean section. Therefore, the management should be strengthened, and intervention should be carried out according to the above factors to improve the neonatal outcome.
引文
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[2]揭育猛,孙世兰.影响新生儿蓝光治疗黄疸疗效的多元Logistic分析[J].河北医学,2015,21(3):466-469.
[3]丁国芳.新生儿黄疸干预推荐方案[J].中华儿科杂志,2001,38(3):185-187.
[4]曹菊英,李虎,钱锋,等.培菲康联合蓝光照射治疗新生儿黄疸疗效观察[J].现代中西医结合杂志,2011,20(14):1744-1745.
[5]SMITH RW,MOHAMED A,YOUNG J,et al.Factors associated with car seat test failure in late preterm infants:A retrospective chart review[J].Paediatr Child Health,2016,21(1):16-20.
[6]NAKIMULI A,MBALINDA SN,NABIRYE RC,et al.Still births,neonatal deaths and neonatal near miss cases attributable to severe obstetric complications:a prospective cohort study in two referral hospitals in Uganda[J].BMC Pediatrics,2015,15(1):44-51.
[7]高志峰,胡丽华.O型孕妇血型抗体效价与新生儿溶血病的相关分析[J].临床血液学杂志:输血与检验,2013,26(2):217-218,221.
[8]谢恬,谭秋婵.孕妇对剖宫产的选择意愿及影响因素分析[J].检验医学与临床,2017,14(17):2549-2551.
[9]张志伟,叶红艳.剖宫产围手术期使用抗菌药物与新生儿高胆红素血症相关性研究[J].中国药业,2015,24(3):52-54.
[10]王海军.120例新生儿高胆红素血症的病因分析[J].现代诊断与治疗,2013,24(7):1626-1627.
[11]逯军,凌瑶君.蓝光联合益生菌口服治疗早产儿黄疸临床观察[J].山东医药,2017,57(9):77-79.
[12]曾秋月,梁腊梅,刘经飘.舒适护理在新生儿黄疸蓝光治疗中的应用效果[J].全科护理,2014,12(26):2448-2450.