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目的探讨围产期各种相关因素与高间接胆红素血症发病的关系。方法选择2011年1月-5月85例产科出生足月高间接胆红素血症患儿血清总胆红素升高(依据其小时龄)达到全国新生儿学组干预推荐方案光疗标准、且结合胆红素<34μmol/L,即高间接胆红素血症。同时按同性别同年龄阶段出生抽取85例无高胆红素血症足月儿按1︰1配对作对照组。采用单因素分析和条件logistic回归分析的方法,筛选高间接胆红素血症发病的危险因素。结果引起高间接胆红素血症的围生因素包括胎龄、产式、窒息、开奶时间延迟、胎粪排出时间延迟、喂养方式、出血、低血糖、红细胞比容和出生体质量下降。其中引起高间接胆红素血症独立的高危围生因素为胎龄、开奶时间延迟、低血糖、出血、红细胞增多症和出生体质量下降。结论临床对具有多种高危围生因素的患儿应提高对其发生高胆红素血症可能的预见性,及早采取预防措施。
Objective To explore the relationship between various related factors of perinatal period and the incidence of high indirect bilirubin. Methods From January to May 2011, 85 children with obstetric birth full-term indirect hyperbilirubinemia with elevated serum total bilirubin (according to their age) to reach the National Neonatology intervention recommended light therapy standards, and Bilirubin <34μmol / L, that is, high indirect bilirubin. At the same time by the same age of the same age were born with 85 cases of full-term children without hyperbilirubinemia by 1: 1 matching for the control group. Univariate analysis and conditional logistic regression analysis were used to screen the risk factors of high indirect hyperbilirubinemia. Results Perinatal factors causing high indirect hyperbilirubinaemia included gestational age, birth pattern, asphyxia, delayed opening of milk, delayed excretion of meconium, feeding patterns, bleeding, hypoglycemia, hematocrit and birth weight decline. The high-risk perinatal factors that cause high indirect hyperbilirubinemia are gestational age, delayed opening of milk, hypoglycemia, hemorrhage, polycythemia and decreased birth weight. Conclusion The clinical treatment of children with multiple high-risk perinatal factors should raise their predictive potential for hyperbilirubinemia and take precautionary measures as soon as possible.