光疗后新生儿经皮胆红素测量的准确性
Accuracy of transcutaneous bilirubin measurement in newborns after phototherapy.
作者信息
Casnocha Lucanova L, Matasova K, Zibolen M, Krcho P
机构信息
Department of Neonatology, University Hospital Martin and Jessenius Medical Faculty Martin, Comenius University Bratislava, Slovakia.
Department of Neonatology, Children Faculty Hospital Kosice and Medical Faculty, Pavol Jozef Safarik University Kosice, Slovakia.
出版信息
J Perinatol. 2016 Oct;36(10):858-61. doi: 10.1038/jp.2016.91. Epub 2016 Jun 9.
OBJECTIVE
We tested the accuracy of transcutaneous bilirubin (TcB) measure in newborns undergoing phototherapy.
STUDY DESIGN
In a prospective study of 150 term Caucasian neonates, 255 measurements of total serum bilirubin (TSB) and TcB concentration were obtained 2 h after discontinuing phototherapy. TcB measurements obtained on the forehead, sternum, abdomen and covered lower abdomen were statistically compared with the corresponding TSB.
RESULT
TcB consistently underestimated TSB levels significantly. The smallest but significant difference between TSB and TcB was found on the lower abdomen. The correlation between TSB and TcB was found to be moderately close (r=0.4 to 0.5). TcB measurements were inaccurate, regardless of phototherapy technique (Bilibed, conventional phototherapy).
CONCLUSION
Phototherapy significantly interferes with the accuracy of transcutaneous bilirubinometry. TcB measurements performed 2 h after stopping phototherapy were not reliable, even if they were carried out on the unexposed body area. TSB assessment remains necessary, if treatment of hyperbilirubinemia is being considered.
目的
我们测试了接受光疗的新生儿经皮胆红素（TcB）测量的准确性。
研究设计
在一项对150名足月白种人新生儿的前瞻性研究中，在停止光疗2小时后获得了255次总血清胆红素（TSB）和TcB浓度的测量值。对在前额、胸骨、腹部和覆盖的下腹部获得的TcB测量值与相应的TSB进行了统计学比较。
结果
TcB始终显著低估TSB水平。TSB和TcB之间最小但显著的差异出现在下腹部。发现TSB和TcB之间的相关性为中度密切（r = 0.4至0.5）。无论光疗技术（蓝光床、传统光疗）如何，TcB测量均不准确。
结论
光疗显著干扰经皮胆红素测定的准确性。即使在未暴露的身体部位进行测量，在停止光疗2小时后进行的TcB测量也不可靠。如果考虑治疗高胆红素血症，TSB评估仍然是必要的。
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