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新生儿黄疸评估变化的影响。

Influence of changes in the evaluation of neonatal jaundice.

机构信息

Department of Neonatology, Bnai Zion Medical Center, Rappaort Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.

出版信息

Am J Perinatol. 2014 Mar;31(3):203-8. doi: 10.1055/s-0033-1343772. Epub 2013 Apr 24.

Abstract

OBJECTIVE

To study the influence of policy changes in the evaluation of neonatal hyperbilirubinemia on discharge process from the nursery. Changes included early assessment of risk factors by universal umbilical blood sampling for blood type, Coombs test, and glucose-6-phosphate dehydrogenase (G6PD) and universal noninvasive transcutaneous bilirubinometry at discharge.

STUDY DESIGN

The 1,569 newborns (≥ 36 weeks' gestation) admitted after the implementation of changes were compared with the 1,822 born before.

RESULTS

Policy changes improved the diagnosis of G6PD deficiency and ABO incompatibility and decreased the number of referrals from the community for jaundice follow-up. The average number of needlesticks per baby as well as the time required for the analysis of serum bilirubin levels on discharge day decreased. Changes did not significantly increase costs.

CONCLUSION

Changes seem to have improved the quality of medical care, including early identification of risk factors and better follow-up of neonatal hyperbilirubinemia with reduction of pain and increased efficiency.

摘要

目的

研究新生儿高胆红素血症评估政策变化对新生儿科出院流程的影响。变化包括通过对所有新生儿进行脐血样本采集(用于检测血型、Coombs 试验和葡萄糖-6-磷酸脱氢酶[G6PD])和在出院时进行非侵入性经皮胆红素测定,以早期评估危险因素。

研究设计

将实施变化后的 1569 名(胎龄≥36 周)新生儿与实施前的 1822 名进行比较。

结果

政策变化提高了 G6PD 缺乏症和 ABO 不相容性的诊断率,并减少了因黄疸随访而从社区转介的人数。每个婴儿的针刺次数以及出院日分析血清胆红素水平所需的时间均有所减少。变化并未显著增加成本。

结论

这些变化似乎改善了医疗服务质量,包括早期识别风险因素以及通过减轻疼痛和提高效率,更好地管理新生儿高胆红素血症。

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