【摘要】 目的调查引起本地区新生儿极重度高胆红素血症的主要危险因素,探索应对措施,有效地预防核黄疸的发生,减少新生儿死亡率及致残率,提高人口素质。方法回顾性分析2010年1月1日-2016年1月1日三峡中心医院新生儿科的极重度高胆红素血症病例,研究住院患儿的病因构成、日龄、家庭环境及文化程度、院外治疗等情况,分析重庆市新生儿患极重度高胆红素血症的非疾病危险因素,以提出该地区新生儿极重度高胆红素血症的有效干预措施。结果就诊时间、喂养情况、监护人文化、分娩方式、院外治疗情况、出生医院级别、同胎中有高胆红素血症的单因素分析结果比较,差异有统计学意义(P<0.05)。再采用非条件Logistic回归方法结果显示,出生医院级别、分娩方式、监护人文化程度、就诊时间、同胎中有高胆红素血症5个指标为极重度高胆红素血症的独立影响因子。结论导致新生儿极重度胆红素血症的疾病危险因素,如感染、窒息等与对照组比较无统计学意义(P>0.05),但两组患儿就诊时间、喂养情况、监护人文化等非疾病相关因素却有显著差异,故非疾病因素在导致新生儿极重度黄疸中占据重要地位,需引起高度重视。更多还原

【Abstract】 Objective To investigate the main risk factors of extremely severe hyperbilirubinemia in neonates in the region,explore the countermeasures,effectively prevent the occurrence of kernicterus,reduce neonatal mortality and disability rate,improve population quality.Methods From January 1st,2010 to January 1st,2016,the neonates with extremely severe hyperbilirubinemia from Department of Neonatology,Chongqing Three Gorges Central Hospital were analyzed retrospectively. The causes,age,family environment,educational level of guardians,and extramural hospital treatment of hospitalized neonates were researched. The non-disease risk factors of extremely severe hyperbilirubinemia in neonates were analyzed to put forward effective intervention measures. Results There were statistically significant differences in visit time of hospital,feeding status,educational level of guardians,delivery modes,extramural hospital treatment,hospital level of birth,maternal hyperbilirubinemia history( P<0. 05). Nonconditional logistic regression analysis showed that hospital level of birth,delivery modes,educational level of guardians,visit time of hospital,maternal hyperbilirubinemia history were independent influencing factors of extremely severe hyperbilirubinemia in neonates. Conclusion Non-disease factors play important roles in extremely severe hyperbilirubinemia in neonates,which should be paid more attention to.更多还原