有關新生兒篩檢的敘述Newborn Screening
新生兒篩檢的主要目的是早期發現新生兒的先天性代謝異常疾病，其中許多疾病可能導致新生兒出現黃疸等症狀，與新生兒高膽紅素血症有密切關聯。
Newborn screening is a public health program designed to identify infants with certain serious but treatable conditions. These conditions are often caused by errors in an infant’s genes or chemistry. Many of these conditions can lead to serious health problems and even death if not detected and treated early in life.
新生兒篩檢的採血時間通常建議在新生兒出生後 48 小時，此時寶寶的飲食狀況較穩定，採集的血液樣本品質較佳。
The blood sample for newborn screening is typically collected 48 hours after birth. This timing allows the baby's body to adjust to feeding, ensuring a more accurate test result.
穿刺部位應選擇足跟的外面兩側，足跟外側的皮膚較厚，血管豐富，且神經末梢較少，相較於其他部位，在採血時對新生兒造成的疼痛感較低，且足跟外側的皮膚相對清潔，且穿刺後容易包紮，能降低感染的風險。
The blood sample is usually collected from a heel prick. The outer side of the heel is chosen because the skin is thicker, the blood vessels are closer to the surface, and there are fewer nerve endings, minimizing discomfort for the baby. Additionally, the outer heel is easier to clean and bandage, reducing the risk of infection.
為了避免影響檢驗結果，採血時不建議用力擠壓穿刺部位，這可能會導致血液混雜組織液，影響檢驗的準確性。
To avoid diluting the blood sample with tissue fluid, it's important to avoid squeezing the heel during and after the blood collection. This can affect the accuracy of the test results.
新生兒篩檢通常使用專用的採血針，針頭較細，穿刺深度較淺，能有效降低新生兒的疼痛感。使用注射針頭不僅會增加新生兒的疼痛，也可能造成較大的創傷。
A special heel-stick device with a small, sharp blade is used to collect the blood sample. This device causes minimal pain and discomfort for the baby, compared to using a hypodermic needle.
早產兒生理問題Physiological Problems in Preterm Infants
早產兒由於器官發育不完全，會面臨多種生理上的挑戰，包括呼吸系統、消化系統和凝血系統等。
Preterm infants, due to their incomplete organ development, face numerous physiological challenges, including respiratory, digestive, and hematologic systems.
呼吸系統Respiratory System：
新生兒呼吸窘迫症 (NRDS)： 這是早產兒最常見的呼吸道疾病，由於肺泡表面張力素不足導致肺泡塌陷，影響呼吸。
Neonatal Respiratory Distress Syndrome (NRDS): This is the most common respiratory disease in preterm infants, caused by a deficiency in surfactant, leading to alveolar collapse and impaired gas exchange.
其他呼吸道問題： 早產兒的呼吸道較脆弱，容易感染，也可能出現呼吸暫停等問題。
Other Respiratory Problems: Preterm infants have weaker respiratory systems and are more susceptible to infections and apnea.
消化系統Digestive System:
肝臟發育不成熟： 早產兒的肝臟功能尚未完全發育，無法有效地將膽紅素轉換為可溶於水的結合型膽紅素，導致膽紅素在血液中蓄積。
Immature Liver Function: The liver of preterm infants is underdeveloped, leading to an inability to efficiently convert bilirubin into water-soluble conjugated bilirubin, resulting in bilirubin accumulation.
乳糖不耐症： 早產兒腸道酵素系統尚未成熟，乳糖酶不足，導致乳糖不耐。
Lactose Intolerance: Preterm infants have immature intestinal enzyme systems, leading to a deficiency in lactase and lactose intolerance.
餵食困難： 早產兒的吸吮和吞嚥能力較弱，可能需要鼻胃管或靜脈營養。
Feeding Difficulties: Preterm infants have weak sucking and swallowing reflexes, often requiring nasogastric or parenteral feeding.
壞死性腸炎： 腸道發育不成熟，血流供應不足，容易發生壞死性腸炎。
Necrotizing Enterocolitis: Immature intestinal development and inadequate blood supply increase the risk of necrotizing enterocolitis.
泌尿系統:Urinary System
腎臟功能不全： 腎小管再吸收功能差，可能出現蛋白尿、血尿、尿濃縮功能不良和尿糖等。
Renal Impairment: Impaired renal tubular reabsorption can lead to proteinuria, hematuria, impaired urine concentration, and glucosuria.
血液系統Hematologic System
凝血功能異常： 凝血因子不足，維生素 K缺乏，導致凝血功能異常，易出血。
Coagulation Disorders: Deficiencies in clotting factors and vitamin K lead to coagulation disorders and increased bleeding risk.
貧血： 早產兒容易發生貧血，需要補充鐵劑。
Anemia: Preterm infants are prone to anemia and require iron supplementation.
紅血球壽命短： 早產兒的紅血球壽命比足月兒短，紅血球破壞的速度更快，產生更多的膽紅素。
Short Red Blood Cell Survival: Preterm infants have shorter red blood cell lifespans, leading to increased red blood cell breakdown and higher bilirubin production.
血漿蛋白結合力降低： 早產兒血漿蛋白的結合能力較弱，無法有效地結合膽紅素，導致游離膽紅素濃度升高。
Decreased Plasma Protein Binding: Reduced binding capacity of plasma proteins in preterm infants leads to higher levels of unbound bilirubin.
循環系統Cardiovascular System:
另外持續性肺動脈高壓： 這是一種新生兒心血管疾病，主要表現為肺動脈壓力持續升高，影響肺循環。
Persistent Pulmonary Hypertension: This is a neonatal cardiovascular disease characterized by persistently elevated pulmonary arterial pressure, affecting pulmonary circulation.
也因為肝臟發育不成熟和血液功能異常，導致新生兒高膽紅素血症（新生兒黃疸）與早產兒有密切的關聯。
Due to immature liver function and hematologic abnormalities, preterm infants are at a higher risk of developing neonatal jaundice.
新生兒高膽紅素血症neonatal jaundice
新生兒時期，血液中膽紅素濃度過高，導致皮膚、眼白等部位發黃的現象。
Neonatal jaundice is a condition where a newborn's skin and the whites of their eyes appear yellow due to an excessive level of bilirubin in the blood.
膽紅素是紅血球分解後產生的黃色色素。新生兒肝臟發育尚未成熟，無法有效地將膽紅素轉換為水溶性物質排出體外，容易導致高膽紅素血症。
Bilirubin is a yellow pigment produced when red blood cells break down. Newborn babies have immature livers, which are unable to efficiently convert bilirubin into a water-soluble form for excretion, leading to high levels of bilirubin in the blood.
嚴重者可能導致核黃疸，影響寶寶的神經系統。
Severe cases can lead to kernicterus, a condition that affects the baby's nervous system.
及早餵食則能促進膽紅素的排泄：
Early and frequent feeding can help promote the excretion of bilirubin:
促進腸道蠕動： 餵食能促進腸道蠕動，加速膽紅素的排出。
Stimulates bowel movement: Feeding promotes bowel movement, accelerating the excretion of bilirubin.
增加排便次數： 排便次數增加，有助於將膽紅素從體內排出。
Increases bowel movements: Increased bowel movements help to eliminate bilirubin from the body.
提供能量： 足夠的奶量能提供新生兒所需的能量，維持生理機能的正常運作。(母乳中的某些成分有助於膽紅素的代謝。)
Provides energy: Adequate milk intake provides the newborn with the necessary energy to maintain normal physiological functions. (Certain components in breast milk can help metabolize bilirubin.)
One of the primary treatments for neonatal jaundice is phototherapy.
新生兒高膽紅素血症的主要治療方式之一就是光照治療
翻身確實有助於照光效果，但頻率不一定需要每4小時一次，應根據寶寶的狀況和醫囑調整。
照光距離會因光源種類和寶寶體重而異，並非固定距離。
While turning the baby can indeed enhance the effectiveness of phototherapy, the frequency may not necessarily be every 4 hours. It should be adjusted based on the baby's condition and medical advice.
The distance of the light source from the baby will vary depending on the type of light source and the baby's weight, and is not a fixed distance.
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