呼气末一氧化碳在新生儿黄疸住院评估中的应用研究

Study on the application of end-tidal carbon monoxide in the hospital evaluation of neonatal jaundice

摘要

目的 探讨呼气末一氧化碳(ETCO)在新生儿黄疸住院评估中的作用,为进一步扩充ETCO临床应用范围提供理论依据。方法 选择2021年3月至2022年11月期间在西安市人民医院(西安市第四医院)出生且因黄疸住院的新生儿为研究对象.受试对象在常规治疗的基础上进行ETCO检测,以1.60ppm为截断值分为高水平组(ETCO≥1.60ppm)和低水平组(ETCO<1.60ppm).分别收集两组患儿胎龄、体重、性别、母孕期危险因素、新生儿溶血试验结果等基本信息,以及住院治疗时长、光疗总时长等住院资料进行统计分析。结果 两组患儿性别、剖宫产率、出生体重、母亲分娩时年龄、孕母合并症(围产期感染、胎膜早破、甲状腺功能减低症、妊娠期糖尿病)、脐带异常、羊水污染、溶血试验阳性比较无统计学差异(P>0.05);出生胎龄高水平组低于低水平组,差异具有统计学意义(t=2.107,P=0.038);两组入院小时龄、入院时血清总胆红素(TSB)值、入院时经皮胆红素(TcB)值、TcB百分位无统计学差异(P>0.05);住院期间TcB升高速率高水平组高于低水平组,差异具有统计学意义(t=3.091,P=0.003);住院光疗时长高水平组高于低水平组,差异具有统计学意义(t=2.449,P=0.017);住院总天数两组间无统计学差异(P>0.05).ETCO与TcB升高速率呈正相关关系(r=0.396,P<0.001),而与TSB无相关性(P>0.05)。结论 ETCO能够反应新生儿黄疸患儿TcB升高的速率水平、评估住院光疗时间,具有临床推广价值.

Abstract

Objective To explore the role of end-tidal carbon monoxide (ETCO) in the hospital evaluation of neonatal jaundice and to provide a theoretical basis for expanding the clinical application of ETCO. Methods Newborns born between March 2021 and November 2022 at Xi'an People's Hospital (Xi'an Fourth Hospital) and hospitalized for jaundice were selected as study subjects. On the basis of routine treatment, ETCO measurements were performed. Using 1.60ppm as the cutoff value, the infants were divided into a high-level group (ETCO≥1.60ppm) and a low-level group (ETCO<1.60ppm). Basic information such as gestational age, birth weight, sex, maternal pregnancy risk factors, and neonatal hemolysis test results was collected for both groups, along with hospitalization data including duration of hospital stay and total phototherapy time, for statistical analysis. Results There were no statistically significant differences between the high-level group and the low-level group in terms of gender, cesarean section rate, birth weight, maternal age at delivery, maternal complications (perinatal infection, premature rupture of membranes, hypothyroidism, gestational diabetes), umbilical cord abnormalities, amniotic fluid contamination, or positive hemolysis test results (P>0.05). Gestational age at birth was significantly lower in the high-level group than in the low-level group (t=2.107, P=0.038). There were no significant differences in age at admission (in hours), total serum bilirubin (TSB), transcutaneous bilirubin (TcB), or TcB percentile at admission (P>0.05). The rate of TcB increase during hospitalization was significantly higher in the high-level group than in the low-level group (t=3.091, P=0.003), and the duration of phototherapy was also significantly longer in the high-level group (t=2.449, P=0.017). However, there was no significant difference in the total length of hospital stay between the two groups (P>0.05). ETCO was positively correlated with the rate of TcB increase (r=0.396, P<0.001), but not with TSB (P>0.05). Conclusion ETCO can reflect the rate of TcB increase in neonates with jaundice and help assess the required duration of phototherapy during hospitalization, indicating its potential clinical value for broader application.

关键词

呼气末一氧化碳 / 新生儿 / 黄疸 / 高胆红素血症 / 光疗

Key words

end-tidal carbon monoxide / neonate / jaundice / hyperbilirubinemia / phototherapy

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基金资助

西安市人民医院(西安市第四医院)科研孵化基金项目(FZG73)