婴幼儿黄疸指南.pdf

Journal of Pediatric Gastroenterology and Nutrition
39:115–128 © August 2004 Lippincott Williams & Wilkins, Philadelphia
Guideline for the Evaluation of Cholestatic Jaundice in Infants:
Recommendations of the North American Society for Pediatric
Gastroenterology, Hepatology and Nutrition
Abstract BACKGROUND
Cholestatic jaundice, characterized by elevation of se-
For the primary care provider, cholestatic jaundice in rum conjugated bilirubin, is an uncommon but poten-
infancy, defined as jaundice caused by an elevated con- tially serious condition that indicates hepatobiliary dys-
jugated bilirubin, is an uncommon but potentially serious function. Early detection of cholestatic jaundice by the
problem that indicates hepatobiliary dysfunction. Early primary care provider and timely, accurate diagnosis by
detection of cholestatic jaundice by the primary care the pediatric gastroenterologist are important for suc-
physician and timely, accurate diagnosis by the pediatric cessful treatment and a favorable prognosis. In contrast,
gastroenterologist are important for successful treatment physiologic jaundice and breast milk jaundice, common
and a favorable prognosis. The Cholestasis Guideline causes of jaundice in the first weeks of life, are caused by
Committee of the North American Society for Pediatric an elevation of serum unconjugated bilirubin. Both are
Gastroenterology, Hepatology and Nutrition has formu- self-limited maturational disorders observed in many in-
lated a clinical practice guideline for the diagnostic fants in the first weeks of life.
evaluation of cholestatic jaundice in the infant. The Cho- Cholestatic jaundice affects approximately 1 in every
lestasis Guideline Committee, consisting of a primary 2,500 infants (1,2), and is thus infrequently seen by most
care pediatrician, a clinical epidemiol