Clinical Analysis Of Incipient Neonatal Pathologic Jaundice In Hosptial

Objective:To collect the clinical data of pathologic jaundice of newborn in hospital,analyze and understand its clinical characteristics.Methods:In January 2014 to May 2018 in the first affiliated hospital of nanchang university incipient neonatal pathologic jaundice treated 693 cases as the research object,according to hospital were retrospectively analyzed,it can be divided into preterm infants and full term group,hemolysis and hemolysis group,MRI abnormal MRI with normal group and the serum total bilirubin(TSB)and percutaneous bilirubin group group(TCB),using t test and x2 test,Single factor ANOVA test,linear correlation analysis,single factor analysis and multiple factors Logistic regression model to study the statistical methods such as discussion,The clinical effect of severe pathological jaundice treated with strong blue light was also summarized.Results:1.The main pathogenic factors of the pathological jaundice of term infants are mainly infection and hemolysis,while the preterm infants are mainly infection and suffocation;2.The day age of preterm jaundice and the day age of the peak jaundice were slightly later than that of the term infants(P<0.05),the peak value of serum bilirubin was higher than that of the term infants(P<0.05),and the duration of jaundice was longer than that of the term infants(P<0.05).3.The onset time and peak time of hemolytic jaundice in children were earlier than those in children with non-hemolytic jaundice(P<0.05),and the peak percentage of reticulocyte count in the former group was significantly higher than that in the latter group(P<0.05),and the duration of jaundice was relatively long(P<0.05).Coombs test results were correlated with hemolytic type(P<0.05).4.The duration of jaundice in the abnormal head MRI group was longer than that in the normal group(P<0.05).The results of multivariate Logistic regression analysis showed that the risk factors of typical symmetric hyperintensity in the glabular area in cranial MRI included premature delivery(OR=21.670),infection(OR=39.305),hemolysis(OR=0.008)and TSB 25mg/dL(OR=18.400).5.There was a significant correlation between TCB and TSB(P<0.05,r=0.981).6.The treatment with strong blue light can rapidly reduce the serum bilirubin level in children with severe and extremely severe pathological jaundice,and there was no case of concurrent bilirubin encephalopathy with a good prognosis.Conclusion:1.Infection and hemolysis are still common causes of pathological jaundice.Asphyxia is another risk factor for pathological jaundice of preterm infants.2.The onset time of hemolytic jaundice,the peak time of jaundice was earlier and the duration of jaundice was longer.The percentage of reticulocyte count was a good predictor of hemolysis.3.The risk factors for typical symmetryhigh signal changes in the pallidum in cranial MRI include preterm birth,infection,hemolysis and TSB 25mg/dL.The longer the course of jaundice,the more likely cranial MRI changes will occur;4.TCB can better predict neonatal pathological jaundice,which is significantly related to TSB,and can effectively reduce the risk of iatrogenic damage caused by repeated blood draws in the course of disease management;5.Strong blue light therapy can be used as the preferred treatment for severe and extremely severe pathological jaundice in early stage and before blood exchange.Bilirubin decreases rapidly and there is no occurrence of bilirubin encephalopathy.