摘要
目的 了解母乳性黄疸 (BMJ)患儿胆红素均值及峰值水平 ,探讨BMJ患儿胆红素增高对肝脏及心肌酶的影响 ,寻求最佳干预方案。方法 以 160例确诊为BMJ患儿为研究对象 ,观察黄疸出现及消退时间 ,并行经皮胆红素、血清胆红素测定及心肌酶谱、肝功能等检查 ,并将胆红素 >2 91μmol/L 80例患儿随机分成 4组治疗 ,并评价其疗效。结果 1.BMJ胆红素高峰期在生后 2～ 4周 ,血清胆红素峰值和均值分别为 3 16μmol/L和 2 3 1μmol/L。黄疸消退时间为 6～ 12周 ;2 .经皮测胆红素与血清总胆红素呈正相关 r =0 .92 ;3 .BMJ患儿心肌酶、肝功能、总蛋白、清蛋白、球蛋白、碱性磷酸酶均在正常范围 ;4.继续母乳组、停止母乳组、光疗暂停母乳组、光疗继续母乳组患儿黄疸消退时间以光疗暂停母乳组与光疗继续母乳组患儿黄疸消退时间快 ,但两组间无显著性差异 (P >0 .0 5)。结论 1.经皮测胆仪不仅可作为筛查、随访工具 ,且其结果可代替血清总胆红素作为指导治疗的依据 ;2 .BMJ患儿胆红素对肝功能、心肌酶无影响 ;3 .各组中以光疗不停母乳组黄疸消退时间最快 ,疗效最显著 。
Objective To understand the bilirubin's average and peak levels of infants with breast milk jaundice(BMJ) and to explore whether the increased bilirubin of infants with BMJ has some effects on infant′s liver function and myocardial enzymes, and to find out the best intervention regime for it.Methods One hundred and sixty infants with BMJ were studied.We observed the time when the jaundice appeared and disappeared and performed transcutaneous measurement of total bilirubin (TcB) and simultaneous total serum bilirubin (TSB), myocardial enzymes, liver function, et al .Eighty infants with BMJ whose TSB concentration was above 291 μmol/L were divided into 4 groups ,and the effect of different therapies were assessed.Results 1. The peak level of the bilirubin in infants with BMJ occurred in 2-4 weeks after birth; the peak and average levels of serum bilirubin were 316 μmol/L and 231 μmol/L respectively. The time when jaundice disappeared was in 6-12 weeks after birth;2.There was a positive correlation between TcB and TSB, correlation coefficient was 0.92;3.The myocardial enzymes, liver function, total protein, albumin, globulin, ulkaline phosphatase of infants with BMJ were all within normal limits;4. Among 4 treatment groups including continuous breast-feeding, suspended breast-feeding, photo therapy + suspended breast-feeding, photo therapy+continuous breast-feeding, jaundice in latter groups soon subsided, but there was no significant difference between them ( P >0.05).Conclusions 1. Not only the transcutaneous bilirubin measurement can be used as a tool for screen and following-up survey, but also its data can be used as a basis for direct treatment instead of total serum bilirubin;2. The increased bilirubin in infants with BMJ has no effect on their liver function and myocardial enzymes;3. In 4 treatment groups, the group of photo therapy + continuous breast-feeding showed the quickest disappearance of jaundice, and the curative effect is remarkable. Infants needn't discontinue breast-feeding if they receive photo therapy.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2004年第2期103-104,共2页
Journal of Applied Clinical Pediatrics
关键词
黄疸
母乳性
治疗
预后
婴儿
新生
breast milk jaundice
treatment
prognosis
newborn
