摘要
目的探讨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。
Objective To explore the ways to establish a clinical risk assessment model of neonatal severe hyperbiliru- binemia. 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 bilirubin percentage of P76-P95）. The ROC curve was used to evaluate the clinical predictive effect of the risk assessment model. The corresponding assessment results showed that the area under the ROC curve corre- sponding to the model was 0.735, suggesting that the model had a good risk predictive effect. Conclusion It is practica- ble to establish the evaluation model and predict the risk of severe hyperbilirubinemia in newborns by clinical risk fac- tors combined with pre-discharge bilirubin levels, and the accuracy of model prediction is favorable.
出处
《中国现代医生》
2018年第3期53-55,59,共4页
China Modern Doctor
