Wickremasinghe Andrea C, Karon Brad S, Cook Walter J
Mayo Clinic, Rochester, MN, USA.
Clin Pediatr (Phila). 2011 Dec;50(12):1144-9. doi: 10.1177/0009922811417292. Epub 2011 Oct 18.
OBJECTIVE. To evaluate the effectiveness of transcutaneous bilirubin (TcB) measurement in predicting risk for neonatal hyperbilirubinemia in outpatients. DESIGN. Subjects were infants ≤8 days old seen in an outpatient clinic. Infants discharged with high-risk (HR) or high-intermediate risk (HIR) total serum bilirubin (TSB) values and jaundiced infants were recruited. TSB and TcB (BiliChek) levels were plotted on an hour-specific nomogram to determine risk for hyperbilirubinemia. RESULTS. A total of 79 infants provided 87 sets of TcB and TsB values. Mean bias and standard deviation between TcB and TsB was 1.5 ± 2.1 mg/dL for outpatients, compared with 2.7 ± 1.3 mg/dL for inpatients. The sensitivity and specificity of HR or HIR TcB for predicting an HR or HIR TSB were 87% and 58%, respectively. Of 9 infants readmitted for phototherapy, 1 had a low-risk TcB and high-risk TSB. CONCLUSIONS. TcB screening in the outpatient environment may not be safe and efficient.
目的。评估经皮胆红素（TcB）测量在预测门诊新生儿高胆红素血症风险中的有效性。
设计。研究对象为在门诊就诊的≤8日龄婴儿。招募出院时总血清胆红素（TSB）值为高风险（HR）或高中等风险（HIR）的婴儿以及黄疸婴儿。将TSB和TcB（BiliChek）水平绘制在特定小时的列线图上，以确定高胆红素血症风险。
结果。共有79名婴儿提供了87组TcB和TsB值。门诊患者中TcB与TsB之间的平均偏差和标准差为1.5±2.1mg/dL，住院患者为2.7±1.3mg/dL。HR或HIR TcB预测HR或HIR TSB的敏感性和特异性分别为87%和58%。在9名因光疗再次入院的婴儿中，1名婴儿TcB为低风险而TSB为高风险。
结论。门诊环境中的TcB筛查可能不安全且效率不高。
