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目的 通过收集我国较大范围的母乳喂养正常新生足月儿生理性黄疸的调查资料 ,得出我国部分地区正常新生儿黄疸胆红素的峰值和平均值 ,为临床诊断奠定基础。方法 采取统一课题设计 ,多中心协作的方法 ,对 875例正常足月新生儿自生后第 1天 (2 4h内 )开始每天分别取微量血和经皮测胆红素者 ,监测至胆红素水平相当于 6 8.4μmol/L以下。对其中血清胆红素峰值大于 2 2 0 .5μmol/L的 5 6例 ,做脑干听力诱发电位的测定。 结果 (1)正常足月新生儿生后第 2～ 3天开始出现黄疸 ,第 5天达高峰 ,平均峰值为 (2 0 4± 5 5 ) μmol/L。血清胆红素峰值超过 2 2 0 .5 μmol/L者占 34 .4%。(2 )不同地区 (P <0 .0 1)及不同季节 (P <0 .0 5 )出生的新生儿血清胆红素值差异有显著性。 (3)在围产因素中 ,新生儿早期的胆红素水平与胎龄 (P <0 .0 1)、分娩方式 (P <0 .0 1)、出生 1～ 3d的生理性体重下降 (P <0 .0 0 1)及红细胞压积水平 (P <0 .0 0 1)差异有显著性。结论 正常足月新生儿黄疸出现的时间与国内外其他报道相似 ,但平均峰值高于既往报道的局部人群的峰值 ,更明显高于西方国家的新生儿。血清胆红素峰值超过 2 2 0 .5 μmol/L者占 34 .4%。 5 6例血清胆红素超过 2 2 0 .5 μmol/L的正常足月新生儿的脑干听力?
Objective To collect the peak value and mean value of bilirubin in jaundice of normal newborns in some areas of our country by collecting the survey data of normal neonatal term jaundice in breastfeeding in our country and lay the foundation for clinical diagnosis. Methods A uniform design and multi-center collaborative method were adopted. Eight hundred and eighty five normal full-term newborns were tested for bilirubin and microalbuminuria on the first day after birth (within 24 hours) The level corresponds to 6 8.4μmol / L or less. Fifty-six patients with peak serum bilirubin greater than 220.5 μmol / L were measured for brainstem auditory evoked potentials. Results (1) Jaundice started to appear on the 2nd to 3rd days after birth in normal term newborns and peaked on the 5th day with an average peak of (204 ± 5) μmol / L. Serum bilirubin peak more than 2 2 0. 5 μmol / L accounted for 34.4%. (2) There were significant differences in serum bilirubin values in newborns born in different regions (P <0. 01) and in different seasons (P <0. 05). (3) Among the perinatal factors, the levels of bilirubin in early neonates were significantly lower than those in gestational age (P <0.01), mode of delivery (P <0.01), and physiological body weights 1-3 days after birth P <0.001) and hematocrit levels (P <0.01), the difference was significant. Conclusion The onset of jaundice in normal full-term newborns is similar to that of other reports at home and abroad, but the average peak value is higher than that of the previously reported local population and more significantly higher than that of newborns in western countries. Serum bilirubin peak more than 2 2 0. 5 μmol / L accounted for 34.4%. Fifty-six patients with normal bilirubin over 220.5 μmol / L of brainstem auditory hearing?