Department of Pediatric & Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.
J Perinatol. 2012 Nov;32(11):851-5. doi: 10.1038/jp.2012.10. Epub 2012 Feb 16.
To determine the effect of universal transcutaneous bilirubin (TcB) screening on total serum bilirubin (TSB) blood draws and phototherapy usage.
The subjects were infants ≥ 36 weeks gestation. In period 1, TSB was ordered based on clinical factors. In period 2, all infants underwent predischarge TcB measurement; infants with adjusted TcB values in the high-intermediate or high-risk zones had TSB ordered. Data were extracted through chart review.
TSB measurements per 1000 infants decreased from 717 to 713 (P=0.008) between period 1 and 2, with more outpatient and less inpatient blood draws in period 2. Between periods 1 and 2, total phototherapy decreased from 59 to 39 per 1000 infants (P<0.0001), with less inpatient and more readmission phototherapy.
Universal TcB screening was implemented without increasing total blood draws or phototherapy treatment; however, it was associated with a shift in blood draws and phototherapy usage from inpatients to outpatients.
确定普遍经皮胆红素（TcB）筛查对总血清胆红素（TSB）采血和光疗使用的影响。
研究对象为胎龄≥36 周的婴儿。在第 1 期，根据临床因素来安排 TSB 检查。在第 2 期，所有婴儿在出院前都进行 TcB 测量；调整后的 TcB 值处于中高危区的婴儿将安排 TSB 检查。通过病历回顾提取数据。
与第 1 期相比，第 2 期每 1000 例婴儿的 TSB 测量次数从 717 次减少到 713 次（P=0.008），第 2 期门诊采血次数更多，住院采血次数更少。与第 1 期相比，第 2 期每 1000 例婴儿的总光疗次数从 59 次减少到 39 次（P<0.0001），住院光疗和再次入院光疗次数减少。
普遍的 TcB 筛查的实施并未增加总采血次数或光疗治疗；然而，它与从住院患者向门诊患者转变有关。
