新生儿黄疸的光疗干预指征及相关问题

摘要

新生儿黄疸或新生儿高胆红素血症是新生儿的一种常见现象,多数情况下是一个良性过程.多种因素造成胆红素的产生和清除失衡即可引起高胆红素血症,部分患儿可发展成重度高胆红素血症,可能会导致永久性的神经系统后遗症(核黄疸).光疗是新生儿黄疸常见的治疗方法,应根据本地区、民族等不同因素的流行病学特点,确定日龄或时龄相对应黄疸的干预值,并结合高危因素的评估,给予适时干预,同时避免过度治疗.%Neonatal jaundice or hyperbilirubinemia is a common occurrence in newborns.Most cases of neonatal jaundice have a benign course.Hyperbilirubinemia can be best understood as a balance between the production and elimination of bilirubin,with a multitude of factors and conditions affecting each of these processes.When an imbalance results because of an increase in circulating bilirubin ( or the bilirubin load)to significantly high levels( severe hyperbilirubinemia),it may cause permanent neurologic sequelae( kernicterus),which is preventable if the hyperbilirubinemia is identified early and treated appropriately.Phototherapy for jaundice is a common treatment in neonatal medicine and is used to prevent the neurotoxic effects of bilirubin.Phototherapy for hyperbilirubinemia should be based primarily on total serum bilirubin levels of the infant's age in hours and other factors that affect the risk of bilirubin encephalopathy.