目的 分析新生儿高胆红素血症(neonatal hyperbilirubinemia, NHB)的主要影响因素, 为防控提供临床依据。方法 选取2010年10月-2011年10月在丹阳市人民医院儿科住院治疗的NHB患儿共计147例作为病例组, 选取同时期在本院分娩的正常婴幼儿122例作为对照组。通过查阅新生儿出生记录、住院病例和现场询问获得以下调查内容, 包括产妇一般情况、孕期一般情况、产妇分娩情况、新生儿生长发育情况、临床观察指标、父亲一般情况等。应用非条件多因素二分类Logistic回归分析筛选新生儿高胆红素血症的主要影响的因素。结果 病例组和对照组中男女性别比例、日龄等一般资料差异无统计学意义(P＞0.05)。低出生体重、剖宫产、母乳缺乏、胎粪吸入综合症、高龄初产、妊娠高血压、感染、胎儿窒息、宫内窘迫是引起NHB的独立高危因素。结论 应加强对高龄初产、剖宫产、胎粪吸入综合症和感染等围产危险因素患儿的监护, 积极喂养并及时监测和干预血清胆红素水平, 达到预防和控制NHB的目的。

Objective To explore the main influence factors of neonatal hyperbilirubinemia (NHB), and to provide the clinical basis for the control and prevention of NHB. Methods A total of 147 NHB patients hospitalized in Danyang People's Hospital from October 2010 to October 2011 was selected as case group, 122 normal infants delivered in same hospital at the same period were recruited as control group.The serum bilirubin levels of infants were measured and the questionnaires to their parents were used for data collection.Multifactor logistic regression analysis was conducted to screening the mainly factors of the NHB. Results There were no significant differences in sex ratio, general data of patients and the control group in age (P>0.05).9 factors, including low birth weight, cesarean section, the lack of breast milk, meconium aspiration syndrome, elderly primipara, pregnancy-induced hypertension, infection, asphyxia, intrauterine distress were the main influencing factors of NHB. Conclusion It is necessary to strengthen the monitoring of elderly primipara, splits the palace production, meconium aspiration syndrome and infection in children with these perinatal risk factors, actively feeding and timely monitoring and intervention of serum bilirubin level, achieve the purpose of prevention and control of NHB.