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ObjectiveTo investigate the cause of neonatal bilirubin encephalopathy, clinical manifestations, auxiliary examination and prognosis.MethodSummary 227 cases on clinical information of bilirubin encephalopathy from Jan 2009-dec 2010, analysis TSB, BAEP, NBNA score and follow-up.Results(1) The causes of bilirubin encephalopathy included ABO hemolytic disease, Rh hemolytic disease, G-6-PD deficiency etc.(2) TSB was 469.36±107.54μmol/l, 67 patients were under the test of BAEP, 36 cases were abnormal, NBNA score <37 points were 90 cases, >37 points were 14 cases. Underwent MRI examination was 8 cases, abnormal was 7 cases.(3) 37 mild bilirubin encephalopathy patients had BAEP examination, 12 were abnormal, the abnormality rate was 32.4%, 30 moderate and severe bilirubin encephalopathy patients had BAEP examination, 24 were abnormal, anomalies rate was 80%, mild bilirubin encephalopathy and moderate severe bilirubin encepha-lopathy patients’BAEP abnormalities has significant difference(χ~2 =15.078 ,P=0.000).(4) Mild, moderate and severe bilirubin encephalopathy’s bilirubin was 443.63±89.40μmol/l,507.37±114.08μmol/l, 591.04±116.73μmol/l, respectively. P values of mild vs moderate, moderate vs severe, mild vs severe were 0.003, 0.000 and 0.003 respectively. It’s a statistically significant difference between them. B/A value was 0.80±0.17mg/g in mild bilirubin encephalopathy patients. moderate bilirubin encephalopathy’s B/A value was 0.87±0.23mg/g, while severe’s B/A value was 1.06±0.25mg/g, It’s a statistically significant difference between the three (F=11.597, P=0.000). B/A value was 0.959±0.232mg/g in those with sequelae, B/A value was 0.809±0.206mg/g in those without sequelae, It had a statistically significant difference between them (t = 3.57, P=0.001).(5) 132 were mild bilirubin encephalopathy patients, 12.8% had sequelae, 44 were moderate bilirubin encephalopathy patients, 45.5% had sequelae, 11 were severe bilirubin encephalopathy patients, 72.7% had sequelae, It’s a statistically significant difference between them(H= 32.84 ,P=0.000).(6) Follow-up:connected the parents to know the condition of patients in telephone, 2 cases dead in hospital, lost 40 cases, the number of follow-up is 185 cases, of which 10 died after discharge, 33 patients survived with sequelae , 142 cases who survived without sequelae.Conclusion(1) The primary cause of bilirubin encephalopathy disease is hemolytic disease.(2) Through a comprehensive analysis the indexing of clinical symptoms, serum bilirubin levels, B/A value and BAEP, give the neonate who are with high risk timely and effective medical intervention, then it can effectively prevent the occurrence of bilirubin encephalopathy. it is also beneficial for the prognosis of bilirubin encephalopathy early assessment and guide follow-up work.
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