Clinical Analysis 98 Cases Of Neonatal Bilirubin Encephalopathy

ObjectiveRetrospective analysis of the clinical data of bilirubin encephalopathy,summary and analysis of the causes of bilirubin encephalopathy,risk factors,corresponding means of examination and treatment,to provide evidence for the clinical diagnosis and treatment of the disease.Methods98 cases of neonatal bilirubin encephalopathy born between January 2013 to December 2017,were explicitly diagnosed as newborn children in our hospital.The observation group was set up.At the same time,the diagnosis of neonatal hyperbilirubinemia was randomly selected for the same period.104 cases of children without bilirubin encephalopathy were set as control groups.Retrospective comparison of the clinical data of two groups of children,Including children's general conditions,high-risk factors,associated diseasesand total bilirubin peak(TSB),total bilirubin/the albumin ratio(B/A),jaundice appearance time,jaundice intervention time,etc.summarized the factors affecting the occurrence of neonatal bilirubin encephalopathy,and divided the children in the observation group into warning periods and convulsions according to the clinical manifestations of admission.Two groups,comparison of TSB peak value,B/A value,hearing screening,BAEP,NBNA score,clinical performance at discharge,and summary of findings and treatment methods such as GMs quality assessment,aEEG,and cranial MRI in children in the observation group.Summarize and analyze the clinical manifestation,corresponding auxiliary examination and treatment of neonatal bilirubin encephalopathy.Results1.The single factor analysis showed that the incidence of neonatal hemolysis,sepsis,viscera hemorrhage,erythrocytosis,stressful Purpura,breastfeeding,metabolic acidosis,and dehydration in the children in the observation group was higherthan that of the control group.The difference was statistically significant(P<0.05).The intervention time,TSB peak,B/A value and jaundice of children in the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).2.Multiple factors Logitic regression analysis shows that neonatal hemolysis,sepsis,and jaundice intervention times are high risk factors for bilirubin encephalopathy(P<0.05).3.The observation group TSB peak value,B/A value,BAEP anomaly were higher than warning period,the difference was statistically significant(P<0.05).4.The observation group of children transferred to 97.0% of the hospital,75.5% of the full month,and 24.5% of premature infants.5.The quality of GMs in the observation group was assessed in 35 cases,of which30 cases were normal writhing movements,5 cases of monomorphic full-body movements,and 22 cases of normal restless movements were reviewed afterwards,and3 cases of undisturbed movements were lacking.6.There were 74 cases of cranial MRI in the observation group,including 23 cases with high signal of T1 WI,including bilateral white spheres,bilateral basalganglia,frontal temporal parietal lobe and thalamus.7.33 cases of NBNA score and 37 cases of NBNA score.8.60 cases of hearing screening in the observation group passed 32 cases and failed 28 cases.9.Observation group BAEP 11 cases,of which 7 cases were abnormal.10.Observation group aEEG 6 cases,of which 5 cases were abnormal.11.Observation group blue light irradiation treatment 100%,blood exchange treatment 77.0%,human immunoglobulin treatment 24.0%,static albumin treatment8.0%,hyperbaric oxygen treatment 56%,nutritional neurotherapy 100%.Conclusions1.Neonatal bilirubin encephalopathy is more common in fullterm children.2.Factors that affect the occurrence of neonatal bilirubin encephalopathy:jaundice intervention time,jaundice onset time,TSB peak,B/A value,neonatal hemolytic disease,sepsis,metabolic acidosis,viscera hemorrhage,stressful Purpura,erythrocytosis and dehydration.3.GMs quality assessment,cranial MRI,NBNA score,hearing screening,BAEP,aEEG play an important role in the early diagnosis of bilirubin encephalopathy,evaluation of Yanzhongchengdu and prognosis.4.The majority of cases of bilirubin encephalopathy are transferred to the hospital,and the effect of warning period treatment is better.It tells us that early detection and early intervention play an important role in red-ucing the incide nce of bilirubin encephalopathy and improving its prognosis.