【摘要】：目的分析新生兒光照療法中皮膚遮蓋部位與暴露部位經(jīng)皮膽紅素測量值與血清總膽紅素值的相關(guān)性,為臨床在光照療法中選擇經(jīng)皮膽紅素測量部位提供參考依據(jù)。方法選取2016年1月29日—4月15日收治的112例高間接膽紅素血癥患兒作為研究對象。選取臨床常用的兩個皮膚暴露部位及兩個遮蓋部位作為經(jīng)皮膽紅素的測量部位。在入院時及光照療法過程中采血監(jiān)測血清總膽紅素值,同時測定暴露部位與遮蓋部位的經(jīng)皮膽紅素值。結(jié)果在光照療法中的4個時間點,2個暴露部位的經(jīng)皮膽紅素測量值與血清總膽紅素值相比,差異均具有統(tǒng)計學(xué)意義(均P0.01)。遮蓋部位中,遮蓋的胸骨第二肋正中處皮膚的4次經(jīng)皮膽紅素測量值與血清總膽紅素值相比,差異均無統(tǒng)計學(xué)意義(均P0.05)。當(dāng)血清總膽紅素大于307.8μmol/L(18 mg/dl)時,血清總膽紅素值均高于經(jīng)皮膽紅素測量值,差異均具有統(tǒng)計學(xué)意義(均P0.01)。結(jié)論光照療法中選擇皮膚遮蓋部位,尤以選擇遮蓋的胸骨第二肋正中皮膚測量的經(jīng)皮膽紅素值能更準(zhǔn)確反映血清總膽紅素水平。當(dāng)血清總膽紅素值大于307.8μmol/L(18 mg/dl)時,經(jīng)皮膽紅素測量值不能準(zhǔn)確反映血清總膽紅素水平。
[Abstract]:Objective to analyze the correlation between the measured values of percutaneous bilirubin in skin covering and exposed parts of newborn infants and the serum total bilirubin level in order to provide a reference for clinical selection of the location of percutaneous bilirubin measurement in light therapy. Methods 112 children with hyperbilirubinemia were selected from January 29 to April 15, 2016. Two skin exposed sites and two covering sites were selected as the measuring sites of percutaneous bilirubin. Blood samples were collected at admission and during light therapy to monitor the value of serum total cholin, and the value of transcortical cholin in the exposed site and the covering site was measured at the same time. at the same time, the serum total cholin value was measured at the time of admission and during light therapy. Results at 4 time points in light therapy, there was significant difference between the measured values of transcutaneous bilirubin in the two exposed sites and the total serum cholin value (all P 0.01). The results showed that there was significant difference between the two exposed sites and the serum total cholin value at 4 time points in light therapy (all P 0.01). In the covering part, there was no significant difference between the skin of the middle part of the second rib of the covered sternum and the total serum cholinoid (P0.05). 4 times of percutaneous bilirubin measurement in the middle of the second rib of the covered sternum was not significantly different from the total serum cholinergic value (P0.05). When the serum total bilirubin was higher than 307.8 渭 mol / L (18 mg/dl), the serum total bilirubin level was significantly higher than that measured by percutaneous bilirubin (P0.01). Conclusion selection of skin covering site in light therapy, especially in the middle skin of the second rib of covered sternum, can reflect the level of serum total bilirubin more accurately. When the serum total cholin value was more than 307.8 渭 mol / L (18 mg/dl), the measured value of transdermal bilirubin could not accurately reflect the serum total bilirubin level.
【作者單位】： 四川大學(xué)華西第二醫(yī)院新生兒科/出生缺陷與相關(guān)婦兒疾病教育部重點實驗室;四川大學(xué)華西第二醫(yī)院病案管理科;
【基金】：四川省衛(wèi)生和計劃生育委員會2016年度立項科研課題(16PJ250)
【分類號】：R722.1

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