12天女婴，足月顺产，母乳喂养，生后第3天出现黄疸。近2天皮肤黄染加深，拒奶，体检 发现面色灰暗、易激惹、前囟张力稍高、四肢稍 凉、脐部红肿、有脓性分泌物，肝肋下3cm，肛 温34.5°C。对明确诊断最重要的检査是

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