Analysis Of Clinical Outcomes Of Neonatal Direct Hyperbilirubinemia

Objective To explore the influential factors to neonatal direct hyperbilirubinemia prognosis through clinical analysis and follow-up. Methods Totally 92 infants presenting with neonatal direct hyperbilirubinemia who had come from Neonatal department of Qingdao Children's Hospital and Pediatric Surgery department of Affiliated Hospital of Medical College of Qingdao University from May 2005 to May 2006, were selected randomly to be studied forward-looking and retrospectively. 15 cases lost visit. Follow-up rate is 83.70%. Of the remaining 77 infants, 46 were given medical treatment and 31 got surgical therapy. Analysis of possible influential factors that result in deaths and other adverse prognosis through both of the two groups were medical follow-up visited and their clinical data analyzed, to interpret death rate, assess the quality of life of survivors and compared long-term prognosis of two groups of patients. Results 1. Besides of 8 lost visit, 9 infants died in the 54 cases treated by medical. Of the rest 37 infants, most of them were cured or improved (89.19%). Their head circumferences and intelligence were fallen behind compared to the 32 cases of normal infants, while the weight and height have no statistical significance between the two groups. 2. 38 cases of surgical group, 7 lost visit, 31 cases of children who be followed-up have be divided to two groups in accordance to life and death. There is on statistical difference between the two groups in serum biochemical indicators. The difference is highly statistically significant between survivors of surgery before 90 days and those of surgery after 120 days. There are 8 with healing and 8 with improving in survival of 16 cases. Only three cases of children with common bile duct cysts be tested by intelligence test, the results show that their IQ are normal. 3. The surgical infants got treated significant later than the medicine infants, the death rate and the incidence of adverse prognosis were higher than the medicine infants. Conclusion The neonates with direct hyperbilirubinemia have a high risk of undesired prognosis even death. Especially the cases need surgery, their prognosis were not prospective because of late intervention.