关键词: 高胆红素血症，新生儿, 胆红素, 蓝光治疗, 新生儿护理

Abstract:

Objective To explore the accuracy and reliability of transcutaneous bilirubin（TcB） determination results at different body surface sites in children with hyperbilirubinemia in NICU before，during and after blue light therapy under different total serum bilirubin（TSB） concentrations. Methods Based on convenience sampling，children with hyperbilirubinemia who were admitted to NICU of a tertiary A hospital in Chengdu from March to October，2021 were selected as the investigation subjects，and TcB of forehead，eyebrows，scapula，sternum，back and buttocks were measured in turn within 15 minutes before collecting TSB samples. Paired sample t-test，Pearson correlation analysis，Bland-Altman consistency analysis，sensitivity，specificity and Youden index were used to evaluate the accuracy and reliability of TcB detection results before，during and after blue light therapy under different TSB concentrations. Results 196 children were included，and 310 groups of paired data between TSB and TcB detection results were obtained. Among them，there were 131 groups before blue light therapy，78 groups during blue light therapy and 101 groups after blue light therapy. There were 212 groups with TSB<15 mg/dl（1 mg/dl=17.1 μmol/L），83 groups with TSB<20 mg/dl and 15 groups with TSB>20 mg/dl. Before blue light therapy，there is the good accuracy of TcB in forehead，eyebrow and sternum. During blue light therapy，the accuracy of TcB in the area covered by eyebrows is better;after blue light therapy，TcB results of forehead，scapula，eyebrows and back are more accurate. When TSB<15 mg/dl，the TcB of forehead，scapula，eyebrow and sternum is more accurate and reliable;when 15 mg/dl≤TSB≤20 mg/dl，the results of TcB in the center of eyebrow and sternum are more accurate and reliable;however，when TSB>20 mg/dl，the accuracy and reliability of TcB in all body surface parts are poor. Conclusion The accuracy and reliability of TcB determination results in different parts of children with hyperbilirubinemia in NICU are different in different treatment periods and TSB concentration. When TSB>20 mg/dl，TcB is not recommended as a reference for clinical decision-making.

Key words: Hyperbilirubinemia,Neonate, Bilirubin, Blue Light Therapy, Neonatal Nursing