Li Qian-Qian, Dong Xiao-Yue, Qiao Yu, Yin Yu-Jie, Gao Yan, Zhou Jin-Jun, Yang Li, Zhu Rong-Ping, Wang Fu-Dong, Wan Jun, Xu Yan, Pan Zhao-Jun, Wang Wei-Yuan, Yan Jun-Mei, Han Shu-Ping, Lu Hong-Yan, Hu Yu-Hua, Li Shuang-Shuang, Wang Jin-Xiu, Wu Ming-Fu, Wang Jun, Deng Xiao-Yi, Yu Zhang-Bin
Department of Pediatrics, Maternity Hospital, Nanjing Medical University, Nanjing 210004, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2020 Jul;22(7):690-695. doi: 10.7499/j.issn.1008-8830.2001050.
To investigate the incidence of severe neonatal hyperbilirubinemia and the management on the treatment and follow-up of this disease in Jiangsu Province, China.
The neonates with severe hyperbilirubinemia who were admitted to 13 hospitals in Jiangsu Province from January to December, 2018, were enrolled as subjects. A retrospective analysis was performed on their mediacal data and follow-up data.
In 2018, 740 neonates with severe hyperbilirubinemia were reported from the 13 hospitals in Jiangsu Province, accounting for 2.70% (740/27 386) of the total number of neonates admitted to the department of neonatology. Among these neonates, 620 (83.8%) had severe hyperbilirubinemia, 106 (14.3%) had extremely severe hyperbilirubinemia, and 14 (1.9%) had hazardous hyperbilirubinemia. Four neonates (0.5%) were diagnosed with acute bilirubin encephalopathy. A total of 484 neonates (65.4%) were readmitted due to severe hyperbilirubinemia after discharge from the delivery institution, with a median age of 7 days, among whom 214 (44.2%) were followed up for jaundice at the outpatient service before readmission, with a median age of 6 days at the first time of outpatient examination. During hospitalization, 211 neonates (28.5%) underwent cranial MRI examinations, among whom 85 (40.3%) had high T1WI signal in the bilateral basal ganglia and the globus pallidus; 238 neonates (32.2%) underwent brainstem auditory evoked potential examinations, among whom 14 (5.9%) passed only at one side and 7 (2.9%) failed at both sides. The 17 neonates with acute bilirubin encephalopathy or hazardous hyperbilirubinemia were followed up. Except one neonate was lost to follow-up, and there were no abnormal neurological symptoms in the other neonates.
Neonates with severe hyperbilirubinemia account for a relatively high proportion of the total number of neonates in the department of neonatology. Jaundice monitoring and management after discharge from delivery institutions need to be strengthened. For neonates with severe hyperbilirubinemia, relevant examinations should be carried out more comprehensively during hospitalization and these neonates should be followed up comprehensively and systematically after discharge.
调查中国江苏省重症新生儿高胆红素血症的发病率及其治疗和随访管理情况。
选取2018年1月至12月在江苏省13家医院收治的重症高胆红素血症新生儿作为研究对象。对其病历资料和随访资料进行回顾性分析。
2018年，江苏省13家医院共报告740例重症高胆红素血症新生儿，占新生儿科收治新生儿总数的2.70%（740/27 386）。其中，重度高胆红素血症620例（83.8%），极重度高胆红素血症106例（14.3%），危险性高胆红素血症14例（1.9%）。4例新生儿（0.5%）诊断为急性胆红素脑病。共有484例新生儿（65.4%）在分娩机构出院后因重度高胆红素血症再次入院，中位年龄为7天，其中214例（44.2%）在再次入院前在门诊进行了黄疸随访，首次门诊检查时的中位年龄为6天。住院期间，211例新生儿（28.5%）接受了头颅MRI检查，其中85例（40.3%）双侧基底节和苍白球T1WI信号增高；238例新生儿（32.2%）接受了脑干听觉诱发电位检查，其中14例（5.9%）一侧通过，7例（2.9%）双侧未通过。对17例急性胆红素脑病或危险性高胆红素血症新生儿进行了随访。除1例失访外，其余新生儿均无异常神经症状。
重症高胆红素血症新生儿在新生儿科收治新生儿总数中占比较高。分娩机构出院后的黄疸监测和管理需要加强。对于重症高胆红素血症新生儿，住院期间应更全面地进行相关检查，出院后应进行全面、系统的随访。
