新生儿黄疸预防及护理的最佳证据总结

doi:10.3761/j.issn.1672-9234.2023.03.021

摘要/Abstract

摘要：

目的总结新生儿黄疸预防及管理的证据，为临床实践提供参考。方法系统检索UpToDate、Cochrane Library、PubMed、Embase、中国知网等中英文数据库中关于新生儿黄疸预防及管理的证据，包括指南、系统评价、临床决策、证据总结、专家共识等，检索时限为建库至2022年4月。2名研究者独立对文献质量进行评价，并提取、汇总相关内容形成最佳证据。结果共纳入14篇文献，包括指南4篇、系统评价4篇、临床决策3篇、证据总结1篇、专家共识 2篇，形成4个方面（预防与评估、管理与治疗、健康教育、出院与随访）的24条最佳证据。结论该研究总结了关于新生儿黄疸预防及管理的最佳证据，可为相关科室护士及管理者提供一定的循证依据。建议护士结合科室和新生儿的实际情况，制订相应的护理措施，改善新生儿不良健康结局。

关键词: 黄疸, 新生儿, 疾病管理, 循证护理学

Abstract:

Objective To summarize the evidence on the prevention and management of neonatal jaundice to provide references for clinical practice. Methods A comprehensive literature search was conducted in Chinese and English databases，such as UpToDate，Cochrane Library，PubMed，Embase，and CNKI. Guidelines，systematic reviews，clinical decisions，evidence summaries and expert consensuses were all eligible for the inclusion criteria. The search time limit was from database inception to April 2022. Two researchers independently evaluated the quality of the included studies，and extracted and summarized the best evidence. Results A total of 14 articles were included，including 4 guidelines，4 systematic reviews，3 clinical decisions，1 evidence summary and 2 expert consensus articles. Twenty-four best pieces of evidence were formed from 4 aspects（prevention and evaluation，management and treatment，health education，and discharge and follow-up）. Conclusion This study summarizes the best evidence on the prevention and management of neonatal jaundice，which can provide some evidence-based basis for nurses and managers in relevant departments. It is suggested that nursing measures should be made according to the actual conditions of departments and newborns in order to improve the health outcomes of newborns.

Key words: Jaundice, Neonatal, Disease Management, Evidence-Based Nursing

盖莹, 李淑英, 李唱, 耿小婷. 新生儿黄疸预防及护理的最佳证据总结[J]. 中华护理教育, 2023, 20(3): 362-367.

GAI Ying, LI Shuying, LI Chang, GENG Xiaoting. Summary of the best evidence for prevention and management of neonatal jaundice[J]. Chinese Journal of Nursing Education, 2023, 20(3): 362-367.

图/表 3

参考文献 25

[1]	王卫平, 孙锟, 常立文. 儿科学[M]. 9版. 北京: 人民卫生出版社, 2018.
[2]	Olusanya B O, Michael K, Hansen T. Neonatal hyperbilirubinaemia:a global perspective[J]. Lancet Child & Adolescent Health, 2018, 2(8):610-620.
[3]	韦当, 王聪尧, 肖晓娟, 等. 指南研究与评价(AGREEⅡ)工具实例解读[J]. 中国循证儿科杂志, 2013, 8(4):316-319.
[4]	张方圆, 沈傲梅, 曾宪涛, 等. 系统评价方法学质量评价工具AMSTAR 2解读[J]. 中国循证心血管医学杂志, 2018, 10(1):14-18.
[5]	胡雁, 郝玉芳. 循证护理学[M]. 2版. 北京: 人民卫生出版社, 2018.
[6]	林楠, 诸纪华, 徐红贞, 等. 早产儿体位管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(4):486-492. doi: 10.3761/j.issn.0254-1769.2022.04.016
[7]	王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11):964-967.
[8]	Anand P, Chairperson M S, Gopalakrishnan S, et al. Screening,prevention,and management of neonatal hyperbilirubinemia guideline development group(Alphabetical)[J]. Journal of Neonatology, 2020, 34(3):153-169. doi: 10.1177/0973217920974163
[9]	National Institute for Health and Care Excellence. Jaundice in newborn babies under 28 days[EB/OL]. (2016-10-26)[2022-04-02]. https://www.nice.org.uk/guidance/cg98.
[10]	Queensland Clinical Guidelines:Neonatal jaundice[EB/OL]. (2019-06-10)[2022-03-26]. https://guide.medlive.cn/guideline/18351.
[11]	Çoban A, Türkmen MK, Gürsoy T. Turkish Neonatal Society guideline to the approach,follow-up,and treatment of neonatal jaundice[J]. Turk Pediatri Ars, 2018, 53(Suppl 1):S172-S179.
[12]	Feng Q, Huang ZY, Su LJ, et al. Therapeutic efficacy and safety of Yinzhihuang granules with phototherapy in neonatal pathologic jaundice:an updated systematic review and meta-analysis[J]. Phytomedicine, 2022, 100:154051. doi: 10.1016/j.phymed.2022.154051
[13]	van Rostenberghe H, Ho JJ, Lim CH, et al. Use of reflective materials during phototherapy for newborn infants with unconjugated hyperbilirubinaemia[J]. Cochrane Database Syst Rev, 2020, 7:CD012011.
[14]	杨爱玲, 冯雅敏, 张有成. 抚触和穴位按摩配合蓝光照射治疗新生儿黄疸效果的Meta分析[J]. 西部中医药, 2021, 34(6):67-74.
[15]	张霞, 韩姗姗, 丁樱, 等. 清肝利胆口服液治疗新生儿黄疸的有效性和安全性评价[J]. 河南中医, 2019, 39(6):871-877.
[16]	Wong RJ, Bhutani VK. Unconjugated hyperbilirubinemia in term and late preterm infants:management[EB/OL]. (2021-12-02)[2022-03-26]. http://www-uptodate-com-443.bjmu.ilibs.cn/contents/unconjugated-hyperbilirubinemia-in-term-and-late-preterm-infants-management.
[17]	Wong RJ, Bhutani VK. Unconjugated hyperbilirubinemia in term and late preterm infants:screening[EB/OL]. (2021-10-22)[2022-03-26]. http://www-uptodate-com-443.bjmu.ilibs.cn/contents/unconjugated-hyperbilirubinemia-in-term-and-late-preterm-infants-screening.
[18]	Wong RJ, Bhutani VK. Unconjugated hyperbilirubinemia in the newborn:interventions[EB/OL].(2021-11-10)[2022-03-26]. http://www-uptodate-com-443.bjmu.ilibs.cn/contents/unconjugated-hyperbilirubinemia-in-the-newborn-interventions.
[19]	MSpPath GK. Neonatal jaundice:phototherapy[EB/OL]. (2021-04-07)[2022-03-24]. https://ovidsp.dc1.ovid.com/ovid-a/ovidweb.cgi?&S=AIPGFPMIPIACPGIBKPNJAGPMAOMKAA00&Link+Set=S.sh.21%7c1%7csl_190.
[20]	中华医学会儿科学分会新生儿学组,《中华儿科杂志》编辑委员会. 新生儿高胆红素血症诊断和治疗专家共识[J]. 中华儿科杂志, 2014, 52(10):745-748.
[21]	张巍, 侯新琳. 新生儿黄疸管理流程共识[J]. 中国优生与遗传杂志, 2021, 29(3):297-299.
[22]	Wickremasinghe AC, Kuzniewicz MW, McCulloch CE, et al. Efficacy of subthreshold newborn phototherapy during the birth hospitalization in preventing readmission for phototherapy[J]. JAMA Pediatr, 2018, 172(4):378-385. doi: 10.1001/jamapediatrics.2017.5630 pmid: 29482208
[23]	Chang PW, Kuzniewicz MW, McCulloch CE, et al. A clinical prediction rule for rebound hyperbilirubinemia following inpatient phototherapy[J]. Pediatrics, 2017, 139(3):e20162896. doi: 10.1542/peds.2016-2896
[24]	Grosse SD, Prosser LA, Botkin JR. Screening for neonatal hyperbilirubinemia-first do no harm?[J]. JAMA Pediatr, 2019, 173(7):617-618. doi: 10.1001/jamapediatrics.2019.1194 pmid: 31107538
[25]	Ogunlesi TA, Lesi FE, Oduwole O. Prophylactic intravenous calcium therapy for exchange blood transfusion in the newborn[J]. Cochrane Database Syst Rev, 2017, 10(10):CD011048.