不同光源治疗新生儿黄疸疗效观察

Effect of Phototherapy with Different Light on Neonatal Jaundice

目的 探讨不同光源、不同强度光疗治疗新生儿高未结合胆红素血症的最佳光疗方法 .方法 将 92例符合条件的患高胆红素血症的新生儿随机分为 3组 ,A组采用传统的蓝光光疗 ,B组使用白光光疗 ,C组使用蓝绿光疗毯 ,每例测定光强度 ,胆红素下降到 185 μmol/L时停止光疗 .结果 B组光强度明显大于A组和C组 ,C组光强度明显大于A组 (p<0 .0 0 1) ;平均光疗时间B组显著小于A组和C组 (p<0 .0 0 1和p <0 .0 5 ) ,C组显著小于A组 (p <0 .0 5 ) ;每小时胆红素下降值及下降率B组显著大于A组和C组 (p<0 .0 0 1和p <0 .0 5 ) ,C组显著大于A组 (p <0 .0 5 ) .而每单位光强度 (μw/cm2 /nm)每小时胆红素下降值A组明显大于B组和C组 (p <0 .0 0 1) ,B组和C组差异无显著性(p >0 .0 5 ) .3组再次光疗及副作用例数比较差异无显著性 (p >0 .0 5 ) .结论 光疗效应随光强度的增加而增加 ;常规测定光疗强度 ,使用高强度光疗可避免无效光疗及减少光疗时间 ;相同光强度下蓝光效果优于白光 ,白光易观察病情 ;

Objective Different light sources and intensity were applied to treat the neonatal hyperbilirubinemia for exploring the best way of phototherapy.Methods 92 infants with nonhemolytic hyperbilirubinaemia were randomly divided into three groups: group A(conventional blue light)、 group B(daylight lamp) and group C(blue-green-light pad). Light intensity was measured during the phototherapy.Phototherapy was stopped when bilirubin(Br) concentration was less than 185 micromol/L. Results The sequence of the mean light intensity was group B、group C、group A(p<0.001); The mean duration of phototherapy in the group B was shorter significantly than that in the group A and C(p<0.001 and p<0.05),and the duration of group C was shorter significantly than that of group A(p<0.05).The rate of Br photodegradation per hour in the group B was higher significantly than that in the group A and C. (p<0.001,p<0.05).The rate of bilirubin photodegradation per hour per unit of light intensity in group A was higher significantly than that in group B and C(p<0.001),but there was no significant difference between group B and C. There was no significant difference about the number requiring second exposure and of side-effect among three groups(p>0.05).Conclusions The efficacy of phototherapy increases with increasing of light intensity;Hight-intensity phototherapy can shorten the duration of phototherapy. The blue-light is more effective than daylight and blue-greenlight in same intensity.The daylight faciliated clinical monitoring; The efficacy of phototherapy can be increasesd through increasing the body surface exposure area .