新生儿黄疸240例早期干预疗效分析

Efficacy analysis of early intervention in 240 cases with neonatal jaundice

目的 探讨新生儿黄疸的早期干预时机和方法,防止过度治疗和延误治疗.方法 将未结合胆红素增高的日龄3d以上的足月新生儿240例采用数字表法分为对照组120例和治疗组120例,对照组给予肠道益生菌、茵栀黄口服液等一般治疗,治疗组给予蓝光治疗.观察两组新生儿的治疗时间、黄疸持续时间、完全退黄时间以及28 d随访时的胆红素值.结果 两组新生儿经治疗无1例转换血治疗,无1例发生胆红素脑病;对照组治疗时间、黄疸持续时间、完全退黄时间分别为（7.84±1.79）d、（10.40±1.30）d、（13.85±1.88）d,治疗组分别为（4.55±1.63）d、（8.70±1.50）d、（11.12±1.65）d,两组差异均有统计学意义（t=14.74、9.36、11.70,均P＜0.01）;对照组28 d随访时胆红素为（13.20±2.47） μmol/L,治疗组为（12.06±2.53） μmol/L,两组差异无统计学意义（t=3.52,P＞0.05）.结论 新生儿黄疸的治疗核心是预防胆红素脑病的发生,只要达到黄疸干预推荐标准就应及时干预.蓝光照射是新生儿黄疸的首选干预方法,治疗效果确切;对出生3d以上的健康足月儿,血总胆红素尽管已达到蓝光治疗标准,在严密监测胆红素的前提下,可暂不进行蓝光照射.

Objective To explore the early intervention time and method for neonatal jaundice,to prevent excessive treatment and delay treatment.Methods From July 2014 to June 2014,240 full term neonates with high bilirubin value were divided into treatment group and observation group.The treatment group was given blue light treatment,the observation group was given general treatment such as intestinal probiotics,Yinzhihuang oral liquid.The treatment time,duration of jaundice of newborn babies,full refund yellow bilirubin value of time and follow-up at the 28th day were observed in two groups.Results In the two groups after treatment,without conversion of blood treatment in 1 case,1 case of bilirubin encephalopathy.In the control group,the treatment tine,the duration of jaundice,jaundice time were （7.84 ± 1.79） d,（10.40 ± 1.30） d,（13.85 ± 1.88） d,which in the treatment group were （4.55 ±1.63）d,（8.70 ± 1.50）d,（1 1.12 ± 1.65）d respectively,there were significant differences between the two groups （t =14.74,9.36,11.70,all P 〈 0.01）.In the control group,the bilirubin level at 28 d follow-up was （13.20 ± 2.47） μ mol/L,that of the treatment group was （12.06 ± 2.53）μ mol/L,there was no significant difference between the two groups（t =3.52,P 〉 0.05）.Conclusion The key of neonatal jaundice treatment is prevent the happening of the bilirubin encephalopathy,as long as jaundice intervention recommendation should be timely intervened.Blue light is the first selection of neonatal jaundice intervention method,treatment effect is exact;Full moon to the health of more than 3 days,total bilirubin blood although has reached the blue-ray standard treatment,on the premise of strict monitoring of bilirubin,can temporarily not blue light.