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目的 :探讨影响新生儿高胆红素血症远期预后的高危因素 ,及急性期临床表现的预测价值。方法 :对 6 3例血清总胆红素水平≥ 342 μmol/L的高胆红素儿 ,分别在 6、 12个月 ,应用InfantsMotorScreen (IMS)和婴幼儿应物、应人和言语能发育的“里程碑”进行监测。结果 :6 3例中 6个月 10例、 12个月 5例 (其中脑性瘫痪 3例 )生长发育异常 ,无死亡。同正常组比较 ,12个月早期高胆儿的发育水平明显落后于正常儿 (P <0 0 5 ) ,以早期新生儿因感染所致者发育水平较低 (P <0 0 1)。结论 :黄疸原因、新生儿日龄是影响高胆儿远期预后的重要参数 ;急性期拥抱反射等 5项临床表现有较高的预测价值 ,动态观察对脑性瘫痪的预测价值大。
Objective: To explore the risk factors influencing the long-term prognosis of neonatal hyperbilirubinemia and the predictive value of clinical manifestations in acute phase. Methods: Sixty-two patients with hyperbilirubinemia with total serum bilirubin level of 342 μmol / L were enrolled in InfantsMotorScreen (IMS) and infants’ Milestones are monitored. Results: Sixty-three cases in 6 months, 10 cases, 12 months in 5 cases (including 3 cases of cerebral palsy) growth and development abnormalities, no death. Compared with the normal group, the developmental level of high cholera in early 12 months was significantly lower than that in normal children (P <0.05). The early neonates had lower level of development due to infection (P <0.01). Conclusions: The causes of jaundice and the age of newborn are the important parameters that affect the prognosis of CHD. The five clinical manifestations of hugging reflex in acute phase have higher predictive value, and the dynamic observation has a great predictive value for cerebral palsy.