| Objective:To calculate the blood bilirubin level and the incidence of high bilirubin encephalopathy in the NICU of Shengjing Hospital affiliated to China Medical University and the NICU of Naqu People’s Hospital,and to analyze and compare them in order to obtain Tibetans with an altitude of 4,500 meters.The differences in blood bilirubin levels and the incidence of hyperbilirubin encephalopathy between neonates and newborns in the Han area provide a theoretical reference for how to intervene in neonatal jaundice and hyperbilirubin encephalopathy in high altitude areas.Methods: 1.Naqu City People’s Hospital NICU received a total of 492 cases of neonates in 2017,of which 229 cases were diagnosed as hyperbilirubinemia,the incidence rate was 46.54%,16 cases of high bilirubin encephalopathy symptoms,the incidence rate was 6.99% In the 2017,a total of 7101 neonates were enrolled in the NIKU Hospital of China Medical University.Among them,603 were diagnosed with hyperbilirubinemia,the incidence rate was 8.49%,and 45 patients developed symptoms of hyperbilirubin encephalopathy.7.46%.2.Among the cases selected,a retrospective analysis of 603 children with hyperbilirubinemia admitted to the NICU of Shengjing Hospital affiliated to China National Medical University from January 2017 to December 2017 and the cases from January 2017 to December 2017 229 children with hyperbilirubinemia admitted to the People’s Hospital of the City of Naqu,recorded the basic conditions of admission to each group(gestational age,gender,hemoglobin value,number of red blood cells,age at admission,highest bilirubin value,whether to change blood And whether or not suffering from bilirubin encephalopathy,etc.,compare the clinical data of the newborns in the plateau and plain areas.3.Analyze and organize data using SPSS 17.0 statistical software.The measurement data is in accordance with the normal distribution and is expressed by the mean±standard deviation,and the non-normal distribution data is expressed by themedian±quartile spacing.The mean-to-group comparison was performed using the unpaired sample t test,and the sample composition ratio or rate was compared using the chi-square test.Results:1.Naqu City People’s Hospital NICU received a total of 492 neonates in2017,229 cases diagnosed as hyperbilirubinemia,the incidence rate was 46.54%,and16 cases diagnosed as bilirubin encephalopathy,the incidence rate 6.99%;Shengjing Hospital NICU received a total of 7101 newborns in 2017,603 cases diagnosed with hyperbilirubinemia,the incidence rate was 8.49%,and 45 cases diagnosed as bilirubin encephalopathy,the incidence rate was 7.46%.2.After case screening,a total of 832 neonates with hyperbilirubinemia were enrolled in the plateau and plain areas.There were 229 cases in the plateau,including99 females and130 males,with a male to female ratio of 1.31:1.There are 603 cases in the plains,including255 females and 348 males.The male to female ratio is about1.36:1.3.In the plateau,the minimum gestational age was 25 weeks,the largest was 39 weeks,and the gestational age was 27 weeks of gestational age <28 weeks in 19 cases(8.3%),28 weeks gestational age <29 weeks 49 cases(21.4%),29 weeks The gestational age was <30 weeks in 10 cases(4.4%),30 weeks gestational age <31weeks 12 cases(5.2%),31 weeks gestational age <32 weeks 29 cases(12.7%),32 weeks gestational age <33 weeks 43 cases(18.8%),33 weeks gestational age < 34 weeks 12 cases(5.2%),34 weeks gestational age < 35 weeks 42 cases(18.3%),35 weeks gestational age < 36 weeks 7 cases(3.1%)),38 weeks gestational age <39weeks(1.3%),39 weeks 3 cases(1.3%).The birth weight is 1000 to 3100 g(median weight 1900 g).In the plain area,the minimum gestational age was 28 weeks,the largest was 42 weeks,and the gestational age was 28 weeks gestational age <29weeks 2 cases(0.3%),29 weeks gestational age <30 weeks 3 cases(0.5%),30 weeks The gestational age was <31 weeks in 13 cases(2.2%),31 weeks gestational age <32weeks 14 cases(2.3%),32 weeks gestational age <33 weeks 10 cases(1.7%),33 weeks gestational age <34 weeks Twenty-three patients(3.8%),34 weeks gestational age <35 weeks 37 cases(6.1%),35 weeks gestational age <36 weeks 35 cases(5.8%),36 weeks gestational age <37 weeks 47 cases(7.8%)),37 weeks gestational age <38weeks 91 cases(15.1%),38 weeks gestational age <39 weeks 81 cases(13.4%),39 weeks gestational age <40 weeks 101 cases(16.7%),40 weeks The gestational age was <41 weeks in 93 cases(15.4%),41 weeks gestational age <42 weeks 47 cases(7.8%),42 cases in 6 cases(1.0%).The birth weight is 970 to 5050 g(median weight3100 g).Conclusion: The level of neonatal bilirubin in the highland area is significantly higher than that in the plain area,but the incidence of high bilirubin encephalopathy is relatively low.It may be associated with high-altitude fetuses in the uterus for a long time in a relatively hypoxic environment,stimulating erythropoietin production.,resulting in increased erythropoiesis.After the newborn leaves the mother,spontaneous breathing is established quickly,the blood oxygen concentration is increased,too many red blood cells are destroyed,and the amount of bilirubin is significantly increased,resulting in high-altitude newborns.The level of bilirubin is higher than that of low altitude;it may also be the difference in genes that determine bilirubin metabolism among different ethnic groups.At present,there are few related studies in this area,which need further study. |
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