目的 比较“互联网+”随访模式与传统随访模式在新生儿黄疸随访中的差异,探讨开展“互联网+”远程黄疸监测”对降低严重高胆红素血症以及胆红素脑病发病率的临床意义。方法 选取2022年1月—2023年10月在山西省儿童医院产科和新生儿科出院的需要随访黄疸的新生儿,根据随访方式不同分为“互联网+”随访模式组(实验组)和传统随访模式组(对照组),每组100例,将两组随访结果进行比较。结果 最终146名新生儿参与随访,其中实验组89名,对照组57名,两组失访率分别为11%和43%,对照组失访率明显高于实验组(χ2=25.988,P＜0.001)。实验组首次远程测经皮胆红素(TcB)值日龄(4.0d)明显早于对照组首次返院测 TcB 日龄(8.0d)(Z=-5.984,P＜0.001)。实验组首测TcB值(9.7mg/dL)低于对照组(12.3mg/dL)(t=4.330,P＜0.001),随访结束远程测TcB次数平均每人为44次,显著高于对照组来院复诊时平均每人测TcB次数4次(Z=-9.679,P＜0.001),实验组高胆红素血症19例(21.3%)低于对照组22例(38.6%)(χ2=5.118,P=0.024),严重高胆红素血症3例(3.4%),低于对照组中的7例(12.2%)(χ2=4.323,P=0.038),差异均有统计学意义。随访依从性受母亲受教育程度(OR=2.578,95%CI:1.338~4.969,P<0.01)及随访模式(OR=2.842,95%CI:1.326~6.091,P<0.01)的影响。结论 “互联网+”远程随访模式无创、简便、可靠,可提高随访依从性,对预防高胆红素血症有重要意义。
Abstract
Objective To compare the differences between the "Internet+" follow-up model and the traditional follow-up model in the follow-up of neonatal jaundice, and to explore the clinical significance of conducting "Internet+" remote jaundice monitoring in reducing the incidence of severe hyperbilirubinemia and kernicterus. Methods Newborns discharged from the obstetrics and neonatology departments of Shanxi Provincial Children's Hospital between January 2022 and October 2023 who required follow-up for jaundice were selected into this study, and were divided into two groups based on the follow-up method: The "Internet+" follow-up model group (experimental group, n=100) and the traditional follow-up model group (control group, n=100). The follow-up results of both groups were compared. Results A total of 146 participants the follow up, with 89 in the experimental group and 57 in the control group. The dropout rates were 11% in the experimental group and 43% in the control group, with the control group's dropout rate significantly higher than that of the experimental group (χ2=25.988, P<0.001). The age at which the first remote transcutaneous bilirubin (TcB) measurement was taken in the experimental group (4.0 days) was significantly earlier than the age at which the first return hospital TcB measurement was taken in the control group (8.0 days) (Z=-5.984, P<0.001). The initial TcB value in the experimental group (9.7mg/dL) was significantly lower than that in the control group (12.3mg/dL) (t=4.330, P<0.001). On average, the number of remote TcB measurements per person in the follow-up period was 44 times, significantly higher than the average of 4 times per person when coming to the hospital for re-examination in the control group (Z=-9.679, P<0.001). The incidence of hyperbilirubinemia in the experimental group (19,21.3%) was significantly higher compared to control group (22, 38.6%) (χ2=5.118, P=0.024); there were 3 cases (3.4%) of severe hyperbilirubinemia in the experimental group, significantly lower than that in the control group(7,12.2%) (χ2=4.323, P=0.038). Factors affecting follow-up compliance included maternal education level (OR=2.578, 95%CI:1.338 - 4.969, P＜0.01) and the follow-up model (OR=2.842, 95%CI:1.326 - 6.091, P＜0.01). Conclusion The "Internet+" remote follow-up model is non-invasive, simple, and reliable, capable of improving compliance with follow-ups and having significant importance in preventing hyperbilirubinemia.
关键词
新生儿黄疸 /
互联网 /
经皮黄疸检测 /
新生儿高胆红素血症 /
胆红素脑病
Key words
neonatal jaundice /
internet /
percutaneous jaundice detection /
neonatal hyperbilirubinemia /
acute bilirubin encephalopathy
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