article丨Liu Jiangqin
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The last article mentioned (newborn jaundice, what doctors are worried about), if the jaundice is very serious, the doctor mainly prevents the progression to bilirubin encephalopathy. The outcome of bilirubin encephalopathy is very bad. Now the incidence of bilirubin encephalopathy is very, very low, because of the complete monitoring system and timely treatment.
Few people know how to check for risky jaundice in our hospital for more than 30,000 deliveries. This includes:
Q
which methods can rule out risky jaundice?
▶ rigorous high-risk assessment before birth;
▶every day after birth, our doctors will go to the mother and baby to do rounds to monitor jaundice;
▶healthy newborns discharged from the hospital with their mothers make an appointment for outpatient follow-up once a week;
▶High Newborns at risk are closely monitored;
▶outpatient phototherapy is for low-risk threshold jaundice levels;
▶day-time phototherapy is for low-risk jaundice and high-risk infants who are sensitive to phototherapy;
▶ inpatient phototherapy is for high-risk and high-level patients jaundice.
clinic often encounters such a situation: children's jaundice is not very high, 10-15mg/dl. Breastfeeding, urination, and mental state are all good. Usually parents are very reluctant to take their children to the outpatient clinic, and hope to get back to pornography quickly. But this is not the best measure. For such a baby, what is the most worrying problem for the doctor?
first need to know that healthy full-term infants over 72 hours of age will not cause bilirubin encephalopathy with jaundice below 20 mg/dl. The toxicity of bilirubin is not a problem for babies with persistent jaundice and no more than 20mg/dl. However, another disease needs to be checked, it is called biliary atresia . Why is
?
Because biliary atresia is diagnosed within 60 days, there is a chance for surgical treatment. The probability of this problem is relatively low, about 1 in 10,000. After three months of liver cirrhosis, the treatment effect is very poor.
Biliary atresia is a congenital disease that can manifest as persistent jaundice in the first 2-3 months after birth. This type of jaundice usually has a darker skin color, called "yin yellow", which is different from the bright yellow (yang yellow) seen in the previous article. But it is generally not easy to detect. This is why I have the following suggestions:
key points:
1, if jaundice persists , do not think that it is caused by breast milk, must be taken to the doctor at least once.
2, the jaundice did not go away within two months, at least one liver function test should be done. Because there is a direct increase in bilirubin due to biliary atresia, transcutaneous jaundice cannot be found.
3. Observe the color of stool. If you have light-colored stool, you must consult a pediatric surgeon.
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