新生儿黄疸时光线疗法量效及总胆红素与经皮胆红素指数关系

The relationship between serum bilirubin level and length of phototherapy and transcutaneous bilirubin index of phototherapy in neonatal jaundice

目的 :探索新生儿黄疸时光线疗法 (光疗 )与血清总胆红素浓度的量效关系及血清总胆红素浓度与经皮胆红素指数之间关系。方法 :用固定光疗装置 ,测定 2 0例足月新生儿黄疸的光线疗法前后及其停止光疗 12、 2 4小时的血清总胆红素浓度与经皮胆红素指数。结果 :连续光疗 48小时后血清总胆红素均值由 16 .6 mg/dl降至 5 .4mg/dl (P <0 .0 0 1)。连续光疗 72小时血清总胆红素浓度并未进一步降低。停止光疗 12、 2 4小时的血清总胆红素均值无明显反跳。光疗前 ,经皮胆红素指数折算的胆红素值与血清总胆红素值并无差别 (t=0 .2 10 0 ,P >0 .0 5 )。光疗 48小时血清总胆红素浓度与经皮胆红素指数也无差别 (t=0 .482 2 ,P >0 .0 5 )。光疗 72小时后经皮胆红素指数折算的胆红素值小于血清总胆红素均值 (2 .5 mg/dl与5 .6 9m g/dl,t=4.6 32 ,P <0 .0 1)。停止光疗 12、 2 4小时后两值无差别。结论 :用所选定光疗装置光照 48小时后血清总胆红素均值下降 11.1m g/dl,连续光照 72小时并未能增加疗效。停止光疗未见血清胆红素浓度值反跳。光疗 72小时 ,皮肤退黄程度大于血清总胆值下降程度。在足月儿黄疸诊治工作中 ,可使用比较简便、无损伤性经皮胆红素仪对足月新生儿黄疸进行监测。

Objective:To clarify the dose effect of phototherapy and relationship between total serum bilirubin(TSB) level,transcutaneous bilirubin index (TcBI) of phototherapy in neonatal jaundice Method:The serum bilirubin and transcutaneous bilirubin index of pre phototherapy,48 and 72 hours after phototherapy,12,24 hours after stopping of phototherapy were measured in 20 jaundiced neonates Results:The total serum bilirubin level were decreased from 16 6mg/dl to 5 4 mg/dl after 48 hours of phototherapy (P<0 001) There are no further decrease on total serum bilirubin after 72 hours of phototherapy After stopping of phototherapy,the jaundice had not been increased Before phototherapy,there are no difference between the value of TSB and TcBI To compare the value of total serum bilirubin and transcutaneous bilirubin index after phototherapy for 48 hours,there are no difference Phototherapy for 72 hours,decreasing of TcBI are more profound than TSB (P<0 001) But there are no difference after stopping of phototherapy Conclusions:After 48 hours of phototherapy the value of total serum bilirubin is decreased about 11 1mg/dl but no further decrease after phototherapy for more 48 hours No rebound of total serum bilirubine had been shown At 72 hours of phototherapy decreasing of TcBI are more significantly than TSB After stopping of phototherapy there are no difference between TcBI and TSB