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足月儿和晚期早产儿出生后96小时内的经皮胆红素列线图

Transcutaneous Bilirubin Nomogram for Healthy Term and Late Preterm Neonates in First 96 Hours of Life.

作者信息

Thakkar Pareshkumar, Chavda Hardas, Doshi Vikas

机构信息

Departments of Pediatrics and *Community Medicine, Medical College and SSG Hospital, Vadodara, Gujarat, India. Correspondence to: Dr Pareshkumar Thakkar, 21, Jay Gayatrinagar Society, Near Amitnagar, VIP Road, Vadodara 390 022, Gujarat, India.

出版信息

Indian Pediatr. 2017 May 15;54(5):369-372. doi: 10.1007/s13312-017-1108-0. Epub 2017 Mar 29.

Abstract

BACKGROUND

To develop nomogram of Transcutaneous Bilirubin among healthy term and late-preterm neonates during first 96 hours of age.

DESIGN

Longitudinal observational study.

SETTING

Neonatal unit of a tertiary care Hospital of Central Gujarat, India.

PARTICIPANTS

1075 healthy term and late preterm neonates (≥35weeks).

INTERVENTION

Six-hourly transcutaneous bilirubin was obtained from birth to 96 hour of life using Drager JM 103 Transcutaneous Bilirubinometer.

METHODS

Main outcome measures: Nomogram of Transcutaneous Bilirubin with percentile values was obtained, rate of rise of bilirubin was calculated and predictive ability of normative data was analyzed for subsequent need of phototherapy.

RESULTS

The age-specific percentile curves and nomogram were developed from the transcutaneous bilirubin readings of 1,010 neonates. Rate of rise in first 12 hour was 0.2 mg/dL and was 0.17 mg/dL in 12 to 24 hour of life which decreased on second day of life. Neonates who required phototherapy had consistently higher readings of transcutaneous bilirubin and also higher rate of rise in first 48 hrs.

CONCLUSION

Neonates whose transcutaneous bilirubin is above the 50th percentile should be monitored for the development of significant hyperbilirubinemia.

摘要

背景

绘制足月儿和晚期早产儿出生后96小时内经皮胆红素的列线图。

设计

纵向观察性研究。

地点

印度古吉拉特邦中部一家三级护理医院的新生儿病房。

参与者

1075名健康足月儿和晚期早产儿(≥35周)。

干预措施

使用德尔格JM 103经皮胆红素仪,从出生至出生后96小时每6小时测量一次经皮胆红素。

方法

主要观察指标:获取经皮胆红素百分位数列线图,计算胆红素上升速率,并分析标准数据对后续光疗需求的预测能力。

结果

根据1010名新生儿的经皮胆红素读数绘制了年龄特异性百分位数曲线和列线图。出生后前12小时胆红素上升速率为0.2mg/dL,出生后12至24小时为0.17mg/dL,出生后第二天下降。需要光疗的新生儿经皮胆红素读数持续较高,且出生后48小时内上升速率也较高。

结论

经皮胆红素高于第50百分位数的新生儿应监测是否发生显著高胆红素血症。

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