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目的:探讨引起新生儿高胆红素血症的危险因素,为新生儿高胆红素血症的预防和治疗提供参考。方法:回顾性分析2010年1月～2011年5月期间于该院新生儿病房住院的高胆红素血症患儿138例,研究入选标准:出生14天之内足月儿血胆红素浓度>220.6μmol/L,出生1个月之内血胆红素浓度早产儿>255μmol/L。应用Logistic回归模型,对临床常见病因如感染、围产因素、早产、ABO溶血等进行回归分析。结果:研究组有138例,对照组有215例。肺炎、剖宫产与药物因素是引起新生儿高胆红素血症的常见原因,其次是早产与窒息。应用多因素Logistic回归分析显示,研究组与对照组相比,肺炎、新生儿窒息、颅内出血、剖宫产与药物及晚期早产因素差异存在统计学意义(P<0.05)。结论:感染和围产因素是高胆红素血症的主要原因。加强围产期保健,避免宫内感染和缺氧,提高围产技术水平,同时加强高危儿的随访及健康教育是降低高胆红素血症发生的工作重点。
Objective: To explore the risk factors of neonatal hyperbilirubinemia and provide reference for the prevention and treatment of neonatal hyperbilirubinemia. Methods: A retrospective analysis of 138 patients with hyperbilirubinemia hospitalized in neonatal ward of the hospital from January 2010 to May 2011 was included in the study. Selection criteria: term bilirubin Concentration> 220.6μmol / L, within 1 month of birth, serum bilirubin concentration of preterm infants> 255μmol / L. Logistic regression model was used to analyze the common clinical causes such as infection, perinatal factors, preterm labor, ABO hemolysis. Results: There were 138 cases in the study group and 215 cases in the control group. Pneumonia, cesarean section and drug factors are common causes of neonatal hyperbilirubinemia, followed by preterm birth and asphyxia. Multivariate Logistic regression analysis showed that the difference between study group and control group was statistically significant (P <0.05) in pneumonia, neonatal asphyxia, intracranial hemorrhage, cesarean section and drug and late preterm birth. Conclusion: Infection and perinatal factors are the main causes of hyperbilirubinemia. Strengthening perinatal care to avoid intrauterine infection and hypoxia, improve perinatal skills, while strengthening the follow-up of high-risk infants and health education is to reduce the incidence of hyperbilirubinemia focus.