Analysis of the Main Cause of Severe Hyperbilirubinemia in Full-Term Infants and Prognosis of Different Therapies
LIU Fang
LIU Tian-tian
REN Chang-jun
LI Ying-mei
GUO Zhi-mei
BAO Li-sha
LYU Shao-guang
Abstract：Objective To study the main cause of severe hyperbilibrubinemia in full-term infants and prognosis. Methods During June 2011 and June 2013, 113 full term infants with the serum total bilirubin level ≥342. 2 μmol/L in newborn service of tertiary hospitals were included, 44 cases (38. 94%) received exchange transfusion, 69 cases (61. 06%) received only phototherapy ( routine therapy group); the common causes, treatment and clinical outcomes were analyzed. Results There were no significant differences of gestational weeks, birth weight, birth approach and the TSB before admis-sion to hospital between the two groups with comparability (P>0. 05). In 113 cases, 51 cases (45. 13%) were iso-immune hemolytic diseases;There was 52. 94% (27/51) of the infants with iso-immune hemolytic diseases in exchange transfusion group, 43. 63% (24/51) in routine therapy group, and no breast-feeding jaundice and physiological jaundice in exchange transfusion group was found. There were no significant differences of infection-related jaundice and perinatal related jaundice between the two groups ( P >0. 05 ); The average age in exchange transfusion group and in routine therapy group showed difference with statistical significance (P<0. 05);Even without accepting exchange transfusion therapy, the full-term infants with severe hyperbilirubinemia due to breast-feeding and physiological factors did not develop chronic bilirubin encephalopa-thy;But for the severe hyperbilirubinemia due to hemolysis and infection, active exchange transfusion therapy could prevent or reduce the occurrence of bilirubin encephalopathy. Conclusion Treatment options for infants with severe hyperbilirubinemia should dependent on the causes and infant's age. For the severe hyperbilirubinemia cases due to hemolysis, and the fact that the patients are less than 7 days, exchange transfusion can reduce the incidence of bilirubin brain injury. Breast feeding to pa-tients of breast feeding or with non-pathological severe hyperbilirubinemia, routine treatment can have good prognosis.
Keywords：HyperbilirubinemianeonatalKernicterusHemolysisCausation of diseasePrognosis
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 40-43 )