文档介绍：该【新生儿黄疸诊治 】是由【小可爱】上传分享，文档一共【34】页，该文档可以免费在线阅读，需要了解更多关于【新生儿黄疸诊治 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。新生儿黄疸诊治Paediatrics&ChildHealth2019;4(2):161-164 -02RevisioninprogressMay2019Paediatrics&ChildHealth2019;12(5):1B-12B -02Guidelinesfordetection,-,particularlythoseinwhombreastfeedingmaynotbefullyestablished,,多为良性。危险的高胆红素血症并不常见,但是有潜在的导致长期神经损害的可能。胆红素水平与胆红素脑病发生Itisestimatedthat60%oftermnewbornsdevelopjaundiceand2%reachaTSBconcentrationgreaterthan340μmol/L().urinfull-terminfantswhosepeakTSBconcentrationremainsbelow340μmol/LandisveryrareunlessthepeakTSBconcentrationexceeds425μmol/L().Abovethislevel,-quartersoftheinfantsintheUnitedStateskernicterusregistry(between1992and2019)hadaTSBconcentrationof515μmol/L(,andtwo-thirdshadaconcentrationexceeding600μmol/L(35mg/dl).Evenwithconcentrationsgreaterthan500μmol/L(),(核黄疸):thepathologicalfindingofdeep-yellowstainingofneuronsandneuronalnecrosisofthebasalganglia(基底节)andbrainstemnuclei(脑干神经元).Acutebilirubinencephalopathy(急性胆红素脑病):aclinicalsyndrome,inthepresenceofseverehyperbilirubinemia,oflethargy(昏睡),hypotoniaand(肌张力减低)poorsuck,whichmayprogresstohypertonia(withopisthotonos(角弓反张)andretrocollis(颈后倾))withahigh-pitchedcryandfever,andeventuallytoseizures(发作)a.?Chronicbilirubinencephalopathy(慢性胆红素脑病):theclinicalsequelaeofacuteencephalopathywithathetoidcerebralpalsy(手足徐动症样大脑麻痹)withorwithoutseizures,developmentaldelay,hearingdeficit,oculomotor(眼球运动异常)disturbances,dentaldysplasia(牙发育异常)andmentaldeficiency.?Severehyperbilirubinemia(严重的高胆红素血症):atotalserumbilirubin(TSB)concentrationgreaterthan340μmol/Latanytimeduringthefirst28daysoflife.?Criticalhyperbilirubinemia(危险的高胆红素血症):aTSBconcentrationgreaterthan425μmol/,高渗,呼吸窘迫,水肿,早产,酸中毒,低白蛋白血症,缺氧,抽搐可增加急性脑病的发生率与败血症的关系?Allofthereasonsforthevariablesusceptibilityofinfantsarenotknown;however,dehydration,hyperosmolarity,respiratorydistress,hydrops,prematurity,acidosis,hypoalbuminemia,hypoxiaandseizuresaresaidtoincreasetheriskofacuteencephalopathyinthepresenceofseverehyperbilirubinemia,,someinfantswithseverehyperbilirubinemiaarefoundtohavesepsis,monintheneonatalperiod,moninthewell-(总体发生情况)Early(days1-2)-monHaemolyticjaundice(ABO,others)Normal(days3-10)-monplicated-seebelowLate(days14+)monConjugatedjaundice-monInheriteddeficiencyofglucuronyltransferaseenzymes-veryrareInvestigations: Measurementofbilirubin 经皮测并不准确(与是否光疗后,皮肤颜色及厚度都有关). ThereareseverallimitationstoTcBmeasurements:eunreliableafterinitiationofphototherapy,andtheymaybeunreliablewithchangesinskincolourandthickness. However,urateatlowerlevelsofbilirubin,andtherefore,‘sRuleRatherthanestimatingthelevelofjaundicebysimplyobservingthebaby'sskincolour,,,theSBRrangeassociatedwithprogressiontothezonesisasfollows:加强光疗的指征曲线