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目的:探索开始喂奶(简称开奶)时间、哺乳频率等因素对母乳喂养性黄疸(BFJ)发生发展的影响,并与生理性黄疸(PJ)作鉴别。方法:按出生后第6天血清胆红素水平及生后第14天黄疸消退与否分为PJ组(n=35)和BFJ组(n=44),分析其开奶时间,出生后头3天每天哺乳次数及排便次数,体重下降百分比,第1次排便时间及排出黄便时间,出生后24~48h自胎便中排出胆红素总量。结果:出生后头3天PJ组和BFJ组每天哺乳次数分别为(5.8±1.9)次/天与(3.7±1.8)次/天,第2天自胎便中排出胆红素的总量分别为(22±5)mg/g与(9±6)mg/g,第1次排胎便时间及排黄便时间分别为(8±4)h、(52±16)h与(12±7)h、(65±17)h,差异均有非常显著意义(P<0.01)。生后第6天血清胆红素BFJ组>(240±31)μmol/L,PJ组<(95±20)μmol/L。结论:喂养的相关参数差异可能是母乳喂养血清胆红素在第1时相异常增高的原因之一。
Objective: To explore the impact of factors such as the time of starting feeding (lactation) and the frequency of breast feeding on the occurrence and development of breastfed jaundice (BFJ), and identify it with physiological jaundice (PJ). Methods: The levels of serum bilirubin on the 6th day after birth and jaundice on the 14th day after birth were divided into PJ group (n = 35) and BFJ group (n = 44) Day lactation frequency and defecation frequency, weight loss percentage, the first defecation time and the time of excretion of yellow stool, after birth 24 ~ 48h since the discharge of bilirubin in the total volume. Results: The number of lactation per day in PJ group and BFJ group was (5.8 ± 1.9) / day and (3.7 ± 1.8) / day respectively after the first 3 days of birth. The total amount of bilirubin excreted in the first trimester of pregnancy was ( 22 ± 5 mg / g and 9 ± 6 mg / g respectively. The time of first defecation and defecation were (8 ± 4) h, (52 ± 16) h and (12 ± 7) h , (65 ± 17) h, the difference was very significant (P <0.01). Serum bilirubin BFJ group (240 ± 31) μmol / L and P (95 ± 20) μmol / L group on the 6th day after birth. Conclusion: The differences of feeding parameters may be one of the reasons that breastfed serum bilirubin is abnormally increased in the first phase.