發(fā)布時間：2018-03-31 00:12

  本文選題：新生兒　切入點：經(jīng)皮膽紅素　出處：《中國現(xiàn)代醫(yī)學雜志》2017年20期

【摘要】：目的利用新生兒小時膽紅素曲線結(jié)合臨床風險因素評分,建立聯(lián)合風險量化矩陣模型,預測貴州省新生兒高膽紅素血癥的發(fā)生風險。方法選取該院產(chǎn)科出生的5 250例足月兒和近足月兒,連續(xù)記錄其出生后168 h的經(jīng)皮膽紅素(TCB)值。將出生后72 h內(nèi)對應的危險區(qū)TCB測定值作為預測指標,建立聯(lián)合風險量化矩陣。結(jié)果使用二次方程對TCB曲線進行二次曲線擬合,結(jié)果顯示,TCB水平在24~48 h內(nèi)上升速率最快,而后逐漸降低。單因素分析結(jié)果顯示,胎齡、分娩方式、胎膜早破及喂養(yǎng)方式與72 h后TCB高危險區(qū)有關(guān)。多因素結(jié)果顯示,72 h后TCB高危險區(qū)與出生體重、分娩方式、胎膜早破及喂養(yǎng)方式有關(guān)聯(lián)。胎齡為36.01~39.99周的研究對象處于72 h后高危險區(qū)的可能性是胎齡≥40.00周研究對象的1.73倍;剖宮產(chǎn)出生的新生兒與順產(chǎn)比較,處于高危險區(qū)的可能性可降低51%;與混合人工喂養(yǎng)相比,人工喂養(yǎng)的研究對象處于高危險區(qū)的可能性較大[^OR=2.173(95%CI:1.267,3.683)]。建立聯(lián)合風險量化矩陣模型,分12個區(qū)。通過釋然比水平高低,將12個區(qū)組分為4個風險水平,用以預測新生兒高膽紅素的發(fā)生可能性。結(jié)論基于聯(lián)合風險量化矩陣和新生兒小時膽紅素百分位數(shù)曲線,將新生兒分為4個風險水平,可對新生兒TCB水平變化開展精準隨訪,有效預防新生兒黃疸的發(fā)生。
[Abstract]:Objective to predict the risk of neonatal hyperbilirubinemia in Guizhou province by using neonatal bilirubin curve and clinical risk factor score.Methods the TCBs of 5 250 full-term and proximal term infants born in obstetrics department of our hospital were recorded continuously at 168 hours after birth.A joint risk quantification matrix was established by using the TCB values of the corresponding risk areas within 72 hours after birth as the predictors.Results the quadratic equation was used to fit the TCB curve. The results showed that the level of TCB rose fastest in 24 h and then decreased gradually.Univariate analysis showed that gestational age, delivery mode, premature rupture of membranes and feeding mode were associated with high risk area of TCB 72 h later.The multivariate results showed that the high risk area of TCB was associated with birth weight, delivery mode, premature rupture of membranes and feeding mode after 72 hours.The study subjects whose gestational age was 36.01 ~ 39.99 weeks were 1.73 times more likely to be in high risk area after 72 hours than those with gestational age 鈮，

本文編號：1688275