Follow-up of neonatal jaundice in term and late premature newborns
Follow-up of neonatal jaundice in term and late premature newborns
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DOI：
10.2223/jped.1676
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发表时间：
2007-08-01
影响因子：
3.3
通讯作者：
Marba, Sergio Tadeu Martins
中科院分区：
文献类型：
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作者：
Facchini, Fernando Perazzini;Mezzacappa, Maria Aparecida;Marba, Sergio Tadeu Martins
目的：报告一项针对新生儿期出现黄疸的足月儿和近月儿的跟踪调查结果。方法：对体重为2000g和/或胎龄为35周的新生儿进行随访，出院时用英格拉姆黄标仪或比利切克黄标仪和Unistat胆红素测定仪(Leica)进行初步评估。这些新生儿的胆红素血症达到或超过了布塔尼绘制的标准图上的第40个百分位数。所有在医院接受光疗的婴儿在停止治疗24小时后用实验室方法重新评估。结果：在11259例新生儿中，2452例(21.8%)转诊至随访门诊，其中87.2%(2140例)已复诊。80名返乡新生儿再次入院。为2452名患者安排了返回预约，其中180名(7.3%)在出院时胆红素血症和GT；=15 mg/dL。在这180人中，有151人返回进行跟进。20例(13.2%)再次入院治疗。在再次入院的总人数中，2名新生儿的血清胆红素水平均为25 mg/dL，无一例为30 mg/dL，均对强化光疗反应迅速，无需换血。结论：该方案能有效地检测和预防足月儿和近月儿高胆红素血症引起胆红素脑病的风险。
Objective: To report on the results of a project following term and near term newborn infants who were jaundiced during the neonatal period.Methods: Neonates were referred to the follow-up clinic with weight >= 2,000 g and/or gestational age >= 35 weeks, and jaundice at discharge was initially assessed with an Ingram icterometer or Bilicheck and, if indicated, with a Unistat bilirubinometer (Leica). These newborn infants had bilirubinemia at or above the 40th percentile on the nomogram developed by Bhutani. All infants treated with phototherapy while in hospital were reassessed by laboratory methods 24 hours after withdrawal of treatment. Patients were rehospitalized for intensive phototherapy if their level was greater than or equal to 20 mg/dL.Results: From a total sample of 11,259 neonates, 2,452 (21.8%) were referred to the follow-up clinic, 87.2% (2,140) of whom did return. Eighty returned neonates were readmitted. Return appointments were set for 2,452 patients, 180 (7.3%) of whom had bilirubinemia >= 15 mg/dL at discharge. Of these 180, 151 returned for follow-up. Twenty (13.2%) were readmitted for treatment. Of the total number of readmitted patients, two newborn infants had levels >= 25 mg/dL and none >= 30 mg/dL All responded rapidly to intensive phototherapy, and there was no need for exchange transfusions.Conclusions: Our results suggest that the regime adopted is effective for detecting and preventing hyperbilirubinemia at risk of causing bilirubin-induced encephalopathy in term and near term newborn infants.