摘要
目的探讨新生儿重症监护病房(NICU)新生儿非结合高胆红素血症(UHB)的影响因素。方法选择2020年8月至2021年5月上海交通大学医学院附属第九人民医院NICU住院的137例UHB新生儿作为UHB组,选择同期99名本院妇产科娩出、未服用任何药物的健康新生儿作为健康对照组。收集两组受试者的临床资料,采用多因素Logistic回归分析NICU住院的新生儿UHB的影响因素。结果UHB组胎龄小于健康对照组[(268±15)d比(272±7)d](P<0.01),出生体质量小于健康对照组[(3168±584)g比(3339±380)g](P<0.01),入院体温低于健康对照组[(36.56±0.36)℃比(36.66±0.23)℃](P<0.05),前额经皮测黄疸高于健康对照组[(228±56)μmol/L比(140±37)μmol/L](P<0.01),UHB组感染性疾病、早产、低体温的比例高于健康对照组[41.6%(57/137)比11.1%(11/99)、17.5%(24/137)比4.0%(4/99)、29.2%(40/137)比8.1%(8/99)](P<0.01),两组喂养方式和出生体质量分布比较差异有统计学意义(P<0.05)。Logistic回归分析结果显示,感染性疾病、低体温是NICU住院的新生儿UHB独立的危险因素(OR=6.580,95%CI 3.073~14.103,P<0.001;OR=4.023,95%CI 1.619~10.003,P=0.003),人工喂养是新生儿UHB的独立保护因素(OR=0.437,95%CI 0.208~0.918,P=0.029)。结论感染性疾病、低体温是NICU中新生儿UHB的独立危险因素,临床需加强对相关危险因素的监测,以降低新生儿UHB的发生率。
Objective To investigate influencing factors of neonatal unconjugated hyperbilirubinemia(UHB)in neonatal intensive care unit(NICU).Methods A total of 137 neonates with UHB admitted to Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine from Aug.2020 to May 2021 were included as a UHB group and 99 healthy newborns delivered from the obstetrics and gynecology department of the same hospital without taking any drugs during the same period were included as a healthy control group.The clinical data of the two groups were collected,and the influencing factors of neonatal UHB in NICU were analyzed by multivariate Logistic regression.Results The gestational age of the UHB group was smaller than that of the healthy control group[(268±15)d vs(272±7)d](P<0.01);the birth weight of the UHB group was lower than that of the healthy control group[(3168±584)g vs(3339±380)g](P<0.01);the body temperature at admission was lower than that of the healthy control group[(36.56±0.36)℃vs(36.66±0.23)℃](P<0.05);the forehead transcutaneous jaundice was higher than that of the healthy control group[(228±56)μmol/L vs(140±37)μmol/L](P<0.01).The proportions of infectious diseases,premature delivery and hypothermia in the UHB group were higher than those in the healthy control group[41.6%(57/137)vs 11.1%(11/99),17.5%(24/137)vs 4.0%(4/99),29.2%(40/137)vs 8.1%(8/99)](P<0.01).There were significant differences in feeding patterns and birth weight distribution between the two groups(P<0.05).Logistic regression analysis showed that infectious diseases and hypothermia were independent risk factors for UHB in neonates hospitalized in NICU(OR=6.580,95%CI 3.073-14.103,P<0.001;OR=4.023,95%CI 1.619-10.003,P=0.003),artificial feeding was an independent protective factor for neonatal UHB(OR=0.437,95%CI 0.208-0.918,P=0.029).Conclusion Infectious diseases and hypothermia are independent risk factors for neonatal UHB in NICU.Clinical monitoring of related risk factors should be strengthened to reduce the incidence of
作者
傅余
张晓英
FU Yu;ZHANG Xiaoying(Department of Pediatrics,Shanghai Ninth People′s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)
出处
《医学综述》
CAS
2023年第18期3720-3724,共5页
Medical Recapitulate
基金
上海市儿童健康服务能力建设项目(沪卫计〔2016〕21号)。
