Xu Chuncai, Bao Yingying, Zhu Jiajun, Teng Yanping, He Yuanyuan, Cheng Ke, Ji Fengjuan, Wu Mingyuan
Department of Neonatology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 Oct 25;49(5):651-655. doi: 10.3785/j.issn.1008-9292.2020.08.08.
To explore the feasibility of remote monitoring of neonatal jaundice in newborns with ABO hemolytic disease.
Forty six neonates of gestational age >35 weeks with ABO hemolytic disease admitted to Women's Hospital, Zhejiang University School of Medicine from January 20th, 2020 to February 29th, 2020 were enrolled in the study (study group). The newborns were followed up at home after discharge, the transcutaneous bilirubin (TCB) levels were measured by parents using the provided device and the results were sent to the doctor by smart phone using the installed APP. Fifty six newborns with ABO hemolytic disease admitted in 2018 who received conventional outpatient follow-up after discharge served as the control group. The demographic characteristics, total serum bilirubin (TSB) level during hospitalization, number of outpatient visit and rate of re-admission due to rebound hyperbilirubinemia were compared between the two groups.
There were no significant differences between the two groups in gestational age, birth weight, delivery mode, gender, length of the first hospitalization, TSB level before phototherapy and before discharge, and the managements during the first hospitalization (all >0.05). Compared with the control group, TSB level before readmission [(265±16) μmol/L vs. (295±15) μmol/L] and the number of outpatient visits (1.3±0.8 vs. 3.8±0.5) were significantly lower in the study group (all <0.01), while the rate of readmission (17.4%vs. 12.5%) and the weight at the time of readmission[(3398±452) g vs. (3477±324) g] were not significantly different (all >0.05). No cases of acute bilirubin encephalopathy occurred in both groups.
The remote follow-up for neonatal jaundice at home can effectively reduce the number of outpatient visits without increasing the risk of readmission and severe neonatal hyperbilirubinemia for newborns with ABO hemolytic disease.
探讨对ABO溶血病新生儿进行新生儿黄疸远程监测的可行性。
选取2020年1月20日至2月29日浙江大学医学院附属妇产科医院收治的46例孕周>35周的ABO溶血病新生儿作为研究对象(研究组)。新生儿出院后在家中进行随访,家长使用提供的设备测量经皮胆红素(TCB)水平,并通过安装的应用程序将结果发送给医生。选取2018年收治的56例ABO溶血病新生儿作为对照组,其出院后接受常规门诊随访。比较两组的人口学特征、住院期间总血清胆红素(TSB)水平、门诊就诊次数及因黄疸反弹再入院率。
两组在孕周、出生体重、分娩方式、性别、首次住院时间、光疗前及出院前TSB水平以及首次住院期间的治疗措施等方面比较,差异均无统计学意义(均>0.05)。与对照组比较,研究组再入院前TSB水平[(265±16)μmol/L比(295±15)μmol/L]及门诊就诊次数(1.3±0.8比3.8±0.5)均明显降低(均<0.01),而再入院率(17.4%比12.5%)及再入院时体重[(3398±452)g比(3477±324)g]差异无统计学意义(均>0.05)。两组均未发生急性胆红素脑病病例。
对ABO溶血病新生儿进行家庭远程随访可有效减少门诊就诊次数,且不增加再入院风险及严重新生儿高胆红素血症的发生风险。