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asbryobvrz · Wysłany: Nie 7:46, 20 Mar 2011

Low-dose erythromycin treatment of feeding intolerance in preterm children Observation (46 cases)

Children in 74 cases, 39 cases of premature children, or 3 days in 28 cases, 4 to 7 days in 57 cases, 8 to 10 days in 28 cases, birth weight 1500 ~ 2499g37 cases, 2500 ~ 3999g70 cases, ~ 4000g6 cases; non-high bilirubin hyperlipidemia group of 127 cases,[link widoczny dla zalogowanych], 66 cases of male and female 6l cases, 85 cases of full-term children, premature children 42 cases, 3 days in 31 cases, 64 cases of 4 to 7 days, 8 to 10 days in 32 cases, birth weight 1500 ~ 2499g43 cases, 2500 ~ 3999g76 cases, ~ 4000g8 cases, percutaneous bilirubin hyperbilirubinemia hyperbilirubinemia group and non-group sex, age, weight, etc. The difference was not statistically significant. 1.2 Measurement of transcutaneous bilirubin transcutaneous jaundice meter used for the production of Tianjin Institute of medical equipment of a type 2 neonatal JD transcutaneous jaundice meter. Measurement sites: the forehead to take both sides of the eyebrow midpoint, the midpoint of the chest to take on both sides of the nipples as the measuring point, will have sufficient power jaundice Probes percutaneous measurement points were aligned vertically so that the probe and the skin round contact, without leaving any gaps, press down the probe, can be displayed on the screen in the instrument readings. A quiet state in the neonatal jaundice, the skin was measured by observing the data, forehead and chest measurements of two different measurement points 1, whichever is recorded as the mean value of transcutaneous bilirubin. At the same time venous blood serum bilirubin, serum bilirubin was measured using Hitachi 7080 automatic biochemical analyzer. Wako of Japan's total company, direct bile agent (vanadate oxidation method) were measured. Criteria for transcutaneous bilirubin 1.3 (transcutaneous jaundice meter) determination: ① measured values within 24h after birth, 96; ② full-term children at any time measured values ≥ 13, premature children measured value ≥ 15,[link widoczny dla zalogowanych], that is judged to be positive, the diagnosis of neonatal hyperbilirubinemia. Serum bilirubin: ① measured values within 24h after birth> 102tmaol / L; ② full-term children at any time the serum bilirubin> 220.6tanol, q_. , Premature children> 255tmaol / L, the diagnosis of neonatal hyperbilirubinemia. . 2 Results 2.1 Determination of serum bilirubin and transcutaneous bilirubin measurement of serum bilirubin Susu hyperlipidemia diagnosis of neonatal hyperbilirubinemia (high bile group) of 112 cases, 128 cases of non-hyperbilirubinemia; Transcutaneous bilirubin diagnosis of 113 cases of neonatal hyperbilirubinemia (serum bilirubin of which 100 high bile group feeding, non-hyperbilirubinemia group 13 cases. that is false positive in 13 cases), non-high bilirubin blood patient group 127 patients (including serum bilirubin hyperbilirubinemia group 12 cases, 115 cases of non-hyperbilirubinemia group, the false negative in 12 cases). 2.2 The sensitivity index 89.29%, specificity was 89.84%,[link widoczny dla zalogowanych], 10.71% rate of missed diagnosis, misdiagnosis rate was 10.42%, 90.55% negative to positive was 88.50%, positive likelihood ratio was 8.79, negative likelihood ratio was 0.12, the accuracy was 89.58%. 3 to discuss the incidence of neonatal hyperbilirubinemia was 9.1% ~ 51%, and bilirubin encephalopathy and high mortality, acute phase of about 50 ~ 70% of the deaths, the survivors about 75% to 90% stay serious neurological sequelae. ... I refer to criteria of pathological jaundice-2J developed neonatal hyperbilirubinemia detection criteria. We used transcutaneous jaundice meter and the determination of serum bilirubin, the diagnosis of neonatal jaundice screening of transcutaneous bilirubin neonatal hyperbilirubinemia in the diagnosis of clinical value. Transcutaneous bilirubin is a yellow dye by measuring the degree of skin estimated neonatal serum bilirubin concentration, a large number of studies have shown that transcutaneous bilirubin measured with the serum bilirubin level was a high degree of linear correlation. Li Yanhui 5 Transcutaneous bilirubin and other reports on the diagnosis of 176 cases of neonatal hyperbilirubinemia, 87.5% diagnostic sensitivity and specificity was 86.6%, accuracy was 86.9% missed diagnosis rate 12.5% misdiagnosis rate was 13.4%, negative 92.4%,[link widoczny dla zalogowanych], positive for the 78.9o, 6. By this group of diagnostic criteria, the diagnosis of neonatal hyperbilirubinemia 89.29% sensitivity and specificity was 89.84 ~, 6, who really was 89.58%, 10.71% rate of missed diagnosis, misdiagnosis rate was 10.42%, 90.55% negative to positive was 88.50%,[link widoczny dla zalogowanych], diagnostic accuracy in this group higher than the reported 2.68%, 1.79% lower rate of missed diagnosis, misdiagnosis rate decreased 2.98 %. Transcutaneous jaundice meter that can accurately reflect the concentration of bilirubin in the blood. Positive likelihood ratio of true positive rate and false positive rate ratio, the greater the value the accuracy of positive results that the more ---- 813 ·----