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1、2018-03—2712:00:30中国现代医生2018年3期魏成胜陈美美杨庆宝［摘要］冃的探討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，资料收集吋间为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化重症高胆红素血症的风险进行评佔，并利用ROCIlli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%。危险因索包括主要危险因索(胎龄35〜36周、出院前胆红索冇分位数＞P95、头颅
2、血肿范围＞3cmx3cm＞出生3d体重下降IO%x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ROCllil线对风险评佔模型的临床预测效果进行评佔，相应的评估结果显示,该模型对应的ROCIlli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索血症的风险情况进行评价模型建立和风险预测切实町行，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；
3、危险因素［中图分类号］R722.1［文献标识码］B［文章编号］1673-9701(2018)03-0053-03ExplorationoftheestablishmentofclinicalriskassessmentmodelofneonatalseverehyperbilirubinemiaWEIChengshenglCHENMeimei2YANGQingbao31・DepartmentofPediatrics,WuhuaCountyWomenandChildren'sHospital,Wuhua514400,China；2.De
4、partmentofGynecologyandObstetrics,WuhuaCountyWomenandChildren'sHospital,Wuhua514400,China；3.DepartmentofNeonatology,WuhuaCountyWomenandChildren'sHospital,Wuhua514400,China［Abstract］ObjectiveToexplorethewaystoestablishaclinicalriskassessmentmodelofneonatalseverehyperbili
5、rubinemia・MethodsTheclinicaldataof756newbornswerecollectedcompletelyforretrospectiveanalysis・ThedatacollectionperiodwasfromJune2016toJune2017.Theclinicalriskfactorscombinedwithpre-dischargebilirubinlevelswereusedfortheevaluationoftherisksofneonatalseverehyperbilirubinem
6、ia,andROCcurvewasusedtotestthepredictiveeffectofthemodel.ResultsAmong756newborninfants,59caseshadseverehyperbilirubinemia,withtheincideneerateof7.80%.Theriskfactorsineludedmajorriskfactors(gestationalageof35-36weeks,pre-dischargebilirubinpercentage＞P95,headhematomarange
7、＞3cmx3cm,birthweightlossover10%xthetotalweight)andminorriskfactors(gestationalageof37weeks,subcutaneouscongestion,mixedfeeding,gestationalageof40weeksandabove,pre-dischargebilirubinpercentageofP76-P95)・TheROCcurvewasusedtoevaluatetheclinicalpredictiveeffectoftheriskasse
8、ssmentmodel.ThecorrespondingassessmentresultsshowedthattheareaundertheROCcurvecorrespondingtothemodelwas0.735,
