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新生儿黄疸:开罗大学新生儿重症监护病房作为转诊中心的问题严重程度。

Neonatal jaundice: magnitude of the problem in Cairo University's neonatal intensive Care unit as a referral center.

机构信息

Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo.

Department of Pediatrics, Ministry of Health, Cairo.

出版信息

Afr Health Sci. 2023 Mar;23(1):656-666. doi: 10.4314/ahs.v23i1.70.

Abstract

BACKGROUND

Neonatal jaundice is one of the most common physiologic problems requiring medical attention in newborns. It is benign in most cases; however, high levels of bilirubin are neurotoxic and can lead to serious brain damage.

OBJECTIVES

This study aimed at assessment of magnitude of neonatal jaundice in cases of neonatal hyperbilirubinemia admitted into neonatal intensive care unit (NICU), Cairo University Pediatric Hospital and to detect possible etiologies, management and outcome.

METHODS

The present work is a retrospective study, included 789 neonates suffered from hyperbilirubinemia over a two-year period.

RESULTS

Intensive phototherapy and exchange transfusion were used together in 6 cases. Two hundreds and twenty-two cases (28.1%) had exchange transfusion once, 44 cases had it twice, 6 cases had it 3 times and one case had it 4 times. Number of exchange transfusion significantly affects mortality among cases (P= 0.02).

CONCLUSION

Neonatal hyperbilirubinemia is an existing problem in our NICU. Intensive phototherapy is an excellent substitute for exchange transfusion. Respiratory distress and sepsis are significantly higher among dead cases. Screening for risk factors is needed to avoid critical hyperbilirubenemia.

摘要

背景

新生儿黄疸是新生儿中最常见的需要医疗关注的生理问题之一。在大多数情况下,它是良性的;然而,高胆红素水平具有神经毒性,并可能导致严重的脑损伤。

目的

本研究旨在评估因高胆红素血症而入住新生儿重症监护病房(NICU)的新生儿黄疸的严重程度,并检测可能的病因、治疗方法和结果。

方法

本研究为回顾性研究,纳入了 789 名在两年期间患有高胆红素血症的新生儿。

结果

有 6 例患儿同时接受了强化光疗和换血治疗。222 例(28.1%)患儿进行了 1 次换血,44 例患儿进行了 2 次,6 例患儿进行了 3 次,1 例患儿进行了 4 次。换血次数显著影响患儿的死亡率(P=0.02)。

结论

新生儿高胆红素血症是我们 NICU 中存在的问题。强化光疗是换血治疗的极好替代方法。在死亡病例中,呼吸窘迫和败血症的发生率明显更高。需要进行危险因素筛查,以避免严重的高胆红素血症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8ff/10398477/6918122dcaef/AFHS2301-0656Fig1.jpg

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