探讨新生儿重症高胆红素血症临床风险评估模型建立.docVIP

探讨新生儿重症高胆红素血症临床风险评估模型建立 　　[摘要] 目的 探?新生儿重症高胆红素血症临床风险评估模型的建立途径。 方法 完整收集756例新生儿的临床资料予以回顾性分析研究，资料收集时间为2016年6月～2017年6月。利用临床危险因素结合出院前胆红素水平的方式对新生儿发生重症高胆红素血症的风险进行评估，并利用ROC曲线对模型的预测效果进行检验。 结果 756例新生儿中有59例新生儿出现重症高胆红素血症，疾病发生率为7.80%。危险因素包括主要危险因素（胎龄35～36周、出院前胆红素百分位数P95、头颅血肿范围3 cm×3 cm、出生3 d体重下降l0%×总体重以上）和次要危险因素（胎龄37周、皮下淤血、混合喂养、胎龄40周及以上、出院前胆红素百分位数为P76～P95）。利用ROC曲线对风险评估模型的临床预测效果进行评估，相应的评估结果显示，该模型对应的ROC曲线下面积为0.735，提示模型具有良好的风险预测效果。 结论 利用临床危险因素结合出院前胆红素水平的方式对新生儿发生重症高胆红素血症的风险情况进行评价模型建立和风险预测切实可行，模型预测准确性良好。 　　[关键词] 重症高胆红素血症；新生儿；风险评估；模型；出院前胆红素水平；危险因素 　　[中图分类号] R722.1 [文献标识码] B [文章编号] 1673-9701（2018）03-0053-03 　　Exploration of the establishment of clinical risk assessment model of neonatal severe hyperbilirubinemia 　　WEI Chengsheng1 CHEN Meimei2 YANG Qingbao3 　　1.Department of Pediatrics， Wuhua County Women and Childrens Hospital， Wuhua 514400， China； 2.Department of Gynecology and Obstetrics， Wuhua County Women and Childrens Hospital， Wuhua 514400， China； 3.Department of Neonatology， Wuhua County Women and Childrens Hospital， Wuhua 514400， China 　　[Abstract] Objective To explore the ways to establish a clinical risk assessment model of neonatal severe hyperbilirubinemia. Methods The clinical data of 756 newborns were collected completely for retrospective analysis. The data collection period was from June 2016 to June 2017. The clinical risk factors combined with pre-discharge bilirubin levels were used for the evaluation of the risks of neonatal severe hyperbilirubinemia， and ROC curve was used to test the predictive effect of the model. Results Among 756 newborn infants， 59 cases had severe hyperbilirubinemia， with the incidence rate of 7.80%. The risk factors included major risk factors（gestational age of 35-36 weeks， pre-discharge bilirubin percentage P95， head hematoma range 3 cm×3 cm， birth weight loss over 10%×the total weight） and minor risk factors（gestational age of 37 weeks，subcutaneous congestion， mixed feeding， gestational age of 40 weeks and above， pre-discharge bilir