摘要
目的 探讨母乳性黄疸的诊断和治疗。方法 对 10 2例母乳性黄疸婴儿的临床表现、实验室检查及治疗进行回顾性分析。结果 1患儿的黄疸出现时间为生后 2～ 15 d,平均 4.6 4d± 2 .76 d,黄疸高峰时间为 5～ 2 0 d,平均 9.2 2 d± 5 .14d,停母乳 2～ 5 d或加光疗等治疗后黄疸消退的时间为生后 2 wk～ 10 wk,平均 32 .6 0 d± 15 .72 d,无核黄疸发生 ;2排除了导致黄疸的其他病理因素 ;3患儿血清胆红素呈不同程度增高 ,均以未结合胆红素增高为主 ,其中血清总胆红素<2 0 5 .2μmol/ L 5 6例 ,2 0 5 .3μmol/ L～ 2 5 6 .4μmol/ L 2 9例 ,2 5 6 .5μmol/ L～ 341.9μmol/ L 13例 ,>342 .6μmol/ L 4例 ,血清总蛋白轻度降低者 48例 ,占总数的 47.0 6 %。结论 母乳性黄疸的诊断要点 :1排除了各种黄疸的病因 ;2高胆红素血症 ;3停母乳 2～ 5 d后黄疸迅速减轻或消退或血清胆红素迅速下降 40 %～ 5 0 %以上 ;近半数患儿血清总蛋白轻度降低 ,可能与本病的发生存在一定的关系。本病治疗简便 ,临床经过及预后均良好。
Objective To evaluate diagnosis and treatment of breast milk jaundice(BMJ) in infants.Methods A retrospective study was performed to analyze the clinical data of 102 infants with BMJ.Results ①The appearance time of jaundice in the patients were the 2nd～15th days after birth;The peak time of jaundice were the 5th～20th days after birth;The disappearance time of jaundice after the patients were stopped breast feeding or added phototherapy for 2～5 days were the 2nd～10th weeks after birth.There was no patient who developed bilirubin encephalopathy.②There was not other pathogenic causes of jaundice in these patients.③Serum bilirubin(mainly indirectbilirubin)concentration of the patients increased in different degree,and serum total protein (TP)level of 48 cases decreased slightly.Conclusions The main diagnostic factors of BMJ were that ①no other pathogenic cause of jaundice;②hyperindirectbilirubinemia;③jaundice reduced rapidly,or the range that serum bilirubin decreased rapidly were more than 40%～50% after the patients were stopped breast feeding for 2～5 days.Lowered serum TP may be concerned with the development of BMJ;The treatment of BMJ were simple and convenient,the process and prognosis of BMJ were also well.
出处
《中国误诊学杂志》
CAS
2001年第3期339-340,共2页
Chinese Journal of Misdiagnostics
关键词
黄疸
诊断
识别
处理
jaundice/diagnosis
distinguishfrom
treatment
