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目的探讨新生儿急性胆红素脑病的病因及临床特点。方法选择2010年1月至2014年12月在我院新生儿救护中心住院,确诊为急性胆红素脑病且出院后随访12个月的新生儿,收集患儿的临床资料,进行回顾性分析。结果共纳入62例新生儿急性胆红素脑病患儿。血清总胆红素(559.9±110.8)μmol/L,其中警告期39例(62.9%),痉挛期23例(37.1%)。黄疸主要原因为溶血19例(30.6%)、感染16例(25.8%)和葡萄糖-65-磷酸脱氢酶(G6PD)缺乏症12例(19.4%)。所有患儿入院即给予光疗,12例接受换血治疗。院内死亡6例,56例患儿临床症状好转出院,出院后死亡5例。随访不良转归26例,完全正常16例。失访9例。结论溶血、感染、G6PD缺乏症是新生儿急性胆红素脑病的主要病因。新生儿急性胆红素脑病病情凶险、病死率高、预后差。应加强宣传,及时就诊加强出院后的随访,以减少胆红素脑病的发生。
Objective To investigate the etiology and clinical features of neonatal acute bilirubin encephalopathy. Methods From January 2010 to December 2014 in our hospital neonatal ambulance center hospitalized, diagnosed as acute bilirubin encephalopathy and discharged 12-month follow-up of newborns, the clinical data were collected for retrospective analysis. Results A total of 62 neonates with acute bilirubin encephalopathy were included. Serum total bilirubin (559.9 ± 110.8) μmol / L, including 39 cases of warning period (62.9%), spasm period of 23 cases (37.1%). The main causes of jaundice were hemolysis in 19 cases (30.6%), infection in 16 cases (25.8%) and glucose-65-phosphate dehydrogenase (G6PD) deficiency in 12 cases (19.4%). All children were given phototherapy on admission, 12 patients underwent transfusions. In-hospital death in 6 cases, 56 cases of children with clinical symptoms improved discharge, 5 patients died after discharge. Follow-up of adverse outcomes in 26 cases, completely normal in 16 cases. Lost to 9 cases. Conclusion Hemolysis, infection and G6PD deficiency are the main causes of neonatal acute bilirubin encephalopathy. Neonatal acute bilirubin encephalopathy in dangerous condition, high mortality, poor prognosis. Should be strengthened publicity, timely follow-up after discharge to enhance follow-up to reduce the incidence of bilirubin encephalopathy.