發(fā)布時(shí)間：2018-05-29 08:36

  本文選題：足月新生兒 + 膽紅素�。� 參考：《安徽醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：通過動態(tài)檢測正常足月新生兒血清總膽紅素（total serum bilirubin TSB），確定淮南市地區(qū)正常足月新生兒生后7天內(nèi)血清總膽紅素變化范圍，為新生兒黃疸干預(yù)提供理論根據(jù)。 方法：(1)對1257例符合納入標(biāo)準(zhǔn)的正常足月新生兒用微量法測定生后第1～7天血清總膽紅素值，計(jì)算各時(shí)間點(diǎn)第25，50，75，95百分位值、觀察其高峰值（peakserum bilirubin PSB)以及高峰出現(xiàn)時(shí)間，，并同步以經(jīng)皮法測定其膽紅素值。(2)隨機(jī)抽取50例新生兒血清標(biāo)本,用生化法測定血清總膽紅素值,并同步以微量法和經(jīng)皮法測定膽紅素值，分別計(jì)算經(jīng)皮膽紅素值（transcutaneous bilirubin TcB）與靜脈血總膽紅素值、末梢微量血膽紅素值與靜脈血總膽紅素值之間的相關(guān)系數(shù)、檢驗(yàn)其統(tǒng)計(jì)學(xué)意義，并得出直線回歸方程；（3）根據(jù)所有新生兒經(jīng)皮膽紅素、末梢微量血膽紅素兩者的同步值，經(jīng)統(tǒng)計(jì)學(xué)處理，進(jìn)行方法學(xué)比較；（4）統(tǒng)計(jì)入選50例新生兒不同皮膚黃染范圍相對應(yīng)的靜脈血總膽紅素值，得出不同皮膚黃染范圍相對應(yīng)的膽紅素估計(jì)值； 結(jié)果：1）1257例該地區(qū)正常足月新生兒生后第1～7天血清膽紅素值的第25、50、75、95百分位值是第1天58.64μmol/L,72.51μmol/L,102.44μmol/L,120.35μmol/L,第2天105.41μmol/L,119.72μmol/L,150.18μmol/L,185.30μmol/L，第3天128.85μmol/L,157.95μmol/L,191.22μmol/L,227.61μmol/L，第4天為160.24μmol/L,191.40μmol/L,216.65μmol/L,277.49μmol/L，第5天164.26μmol/L,179.51μmol/L,209.88μmol/L,263.74μmol/L，第6天131.87μmol/L,172.73μmol/L,195.57μmol/L,231.26μmol/L，第7天118.94μmol/L,157.57μmol/L,204.83μmol/L,223.84μmol/L。PSB為294.46μmol/L，高峰出現(xiàn)在第4天；（2）微量法、經(jīng)皮法均與生化法有良好的相關(guān)性(微量法與生化法r=0.948，t=21.067；經(jīng)皮法與生化法r=0.935，t=18.333)；（3）微量法、經(jīng)皮法對正常足月新生兒的膽紅素進(jìn)行測定,1～3d和6～7d膽紅素測定值兩法比較,差異有統(tǒng)計(jì)學(xué)意義(P＜0.05),第4～5天比較差異無統(tǒng)計(jì)學(xué)意義(P＞0.05)；（4）皮膚黃染在頭面部其血清總膽紅素值為112.3±6.2μmol/L，到胸部為165.1±26.7μmol/L，到腹部為214.0±30.8μmol/L，到膝、肘為268.5±28.2μmol/L，到手、足心為＞271.7μmol/L。 結(jié)論：本研究得出了安徽省淮南市地區(qū)地區(qū)正常足月新生兒生后1～7d血清總膽紅素的變化范圍、高峰值以及高峰出現(xiàn)時(shí)間,為本地區(qū)足月新生兒黃疸的合理干預(yù)提供依據(jù)；以微量法監(jiān)測新生兒血清膽紅素,結(jié)果準(zhǔn)確可靠；通過目測皮膚黃染范圍，初步估計(jì)其膽紅素值，不失為一種簡便易行的方法。
[Abstract]:Objective: to determine the range of changes of serum total bilirubin in normal full-term newborns within 7 days after birth by dynamic detection of total bilirubin in normal term neonates, and to provide theoretical basis for the intervention of neonatal jaundice. Methods Total serum bilirubin was measured in 1257 normal full-term newborns by microanalysis on the 1st day after birth. The total bilirubin was calculated at 25 ~ 50 ~ 75 ~ (95) percentile at each time point, and the peak value (peakserum bilirubin) and the time of peak appearance were observed. The serum bilirubin of 50 newborns was measured by biochemical method, and bilirubin was measured by microanalysis and transcutaneous method simultaneously, and the serum bilirubin value was measured by microanalysis and transcutaneous method simultaneously, and the serum bilirubin was measured by biochemical method, and the serum bilirubin value was measured by transcutaneous method. The correlation coefficient between transcutaneous bilirubin and total bilirubin in venous blood, trace bilirubin in peripheral blood and total bilirubin in venous blood were calculated, respectively. According to the simultaneous values of transcutaneous bilirubin and microbilirubin in peripheral blood of all neonates, the linear regression equation was obtained. The total bilirubin values of venous blood of 50 newborns with different skin yellow staining ranges were selected and the corresponding bilirubin estimates of different skin yellow staining ranges were obtained. 緇撴灉:1)1257渚嬭鍦板尯姝ｅ父瓚蟲湀鏂扮敓鍎跨敓鍚庣1~7澶╄娓呰儐綰㈢礌鍊肩殑絎

本文編號：1950226