静脉注射丙种球蛋白在新生儿早期重症高未结合胆红素血症的临床观察

Clinical Observation of Intravenous Immunoglobulin in Neonatal Severe Unconjugated Hyperbilirubinemia

目的分析新生儿重症高未结合胆红素血症采用静脉注射丙种球蛋白治疗的临床疗效。方法以我院在2020年11月-2021年10月收治的100例新生儿重症高未结合胆红素血症患儿作为研究对象,随机将患儿分为观察组(50例)和对照组(50例),给予对照组患儿实施常规治疗,观察组患儿在常规治疗的基础上给予静脉注射丙种球蛋白治疗,评测两组患儿的显效率、总体治疗效果、发育不良情况及血清胆红素日均下降值、平均光疗时间、52项运动评分、黄疸消退平均时间进行对比分析。结果观察组中显效31例,显效率62.0%,总有效率98.0%,对照组患儿中显效19例,显效率38.0%,总有效率88.0%,观察组患儿治疗显效率、总有效率明显高于对照组患儿(P<0.05);观察组患儿中存在5例发育不良情况,包括2例听力障碍和3例行为发育异常,发育不良情况发生率为10.0%,对照组患儿中存在16例发育不良情况,包括7例听力障碍和9例行为发育异常,发育不良情况发生率为32.0%,观察组患儿发育不良情况发生率明显低于对照组患儿(P<0.05);观察组患儿血清胆红素日均下降值、平均光疗时间、52项运动评分、黄疸消退平均时间明显优于对照组(P<0.05)。结论新生儿重症高未结合胆红素血症采用静脉注射丙种球蛋白具有良好的临床效果。

Objective To analyze the clinical efficacy of intravenous immunoglobulin in the treatment of neonatal severe unconjugated bilirubinemia.Methods Taking 100 neonates with severe hyperunconjugated bilirubinemia admitted in our hospital from November 2020 to October 2021 as the research objects,the children were randomly divided into observation group(50 cases)and control group(50 cases),the children in the control group were given conventional treatment,and the children in the observation group were given intravenous gamma globulin treatment on the basis of conventional treatment.The apparent efficiency,overall treatment effect,dysplasia,average daily decline in serum bilirubin,average phototherapy time,52 sports scores,and average time to jaundice resolution were evaluated for comparison and analysis of the two groups of children.Results In the observation group,31 cases were markedly effective,the markedly effective rate was 62.0%,and the total effective rate was 98.0%.In the control group,19 cases were markedly effective,the markedly effective rate was 38.0%,and the total effective rate was 88.0%.The treatment efficiency and total effective rate of children in the observation group were significantly higher than those in the control group(P<0.05).There were 5 cases of dysplasia in the observation group,including 2 cases of hearing impairment and 3 cases of behavioral development abnormalities.The incidence of dysplasia was 10.0%.There were 16 cases of dysplasia in the control group,including 7 cases of hearing impairment and 9 cases of behavioral dysplasia.The incidence of dysplasia was 32.0%.The incidence of stunting in the observation group was significantly lower than that in the control group(P<0.05).The average daily decline in serum bilirubin,average phototherapy time,52 sports scores,and average time for jaundice resolution in the observation group were significantly better than those in the control group(P<0.05).Conclusion Intravenous injection of gamma globulin has good clinical effect in neonatal severe unconjugated bilirubinemia.