间断蓝光与持续蓝光治疗新生儿黄疸临床疗效及预后比较

Comparison of the effect and prognosis of intermittent blue light and continuous blue light therapy for neonatal jaundice

目的 应用间断与持续蓝光光照不同方式治疗病理性新生儿黄疸,观察临床疗效及对黄疸的改善作用,评估新生儿预后.方法 选择病理性新生儿黄疸214例,均进行蓝光照射治疗,根据入院编号按照单双数随机分为A组和B组,两组各107例,A组给予持续性蓝光照射治疗.B组给予间断性蓝光照射治疗.观察患儿临床疗效及预后、蓝光照射时间、血清总胆红素（TBiL）恢复时间和住院时间,光照治疗期间不良反应;检测光照前、光照后3d、5d血清TBiL水平.结果 B组总有效率为97.18％（104/107）,高于A组90.65％（97/107）,差异有统计学意义（χ2=10.30,P＜0.05）;B组患儿蓝光照射时间和住院时间分别为（71.29±7.05）d和（11.51±1.23）d,低于A组（79.54±6.82）d和（13.64±1.18）d,差异有统计学意义（u=11.42、9.87,P＜0.05）;B组患儿治疗5d后血清TBiL为（96.28±10.25） μmol/L,低于A组（104.52士10.31） μmol/L,差异有统计学意义（u =8.94,P＜0.05）;B组患儿总不良反应发生率为2.55％ （4/157）,低于A组的7.01％（11/157）,差异有统计学意义（χ2=9.66,P＜0.05）.两组患儿预后均良好.结论 间断与持续蓝光光照不同方式治疗病理性新生儿黄疸均具有较好的临床疗效,新生儿预后良好.间断蓝光照射临床疗效对黄疸的改善作用更优,能够显著缩短患儿治疗时间,并具有较高的安全性.

Objective To observe the effect of intermittent and continuous blue light therapy for pathological neonatal jaundice,and to evaluate the prognosis of newborns.Methods 214 patients with pathologic neonatal jaundice who treated with blue light irradiation were slected,they were randomly divided into two groups according to the admission number combined with single and double numbers,107 patients in each group.Group A received continuous blue light irradiation treatment.Group B received intermittent blue light irradiation.The clinical efficacy and prognosis of children,blue light exposure time,serum total bilirubin （TBiL） recovery time,the hospitalization time and the adverse reactions during the treatment were observed.The levels of serum TBiLwere measured before and after light exposure 3,5 days.Results The total effective rate of group B was 97.18% （104/107）,which was higher than that of group A [90.65 % （97/107）],the difference was statistically significant （χ2 =10.30,P 〈 0.05）.The time of blue light irradiation and hospital stay time of group B were （71.59 ± 7.05） d and （11.51 ± 1.23） d,respectively,which were significantly shorter than those of group A [（79.54 ± 6.82） d and （13.64 ± 1.18） d],the differences were statistically significant （u =11.42,9.87,all P 〈 0.05）.The level of TBiL of group B was （96.28 ± 10.25） μmol/L,which was significantly lower than （104.52 ± 10.31） μmol/L of group A （u =8.94,P 〈 0.05）.The incidence rate of adverse reactions in group B was 2.55% （4/157）,which was lower than that in group A [7.01% （11/157）],the difference was statistically significant （χ2 =9.66,P 〈 0.05）.The prognosis of neonatal in the two groups was good.Conclusion The intermittent and continuous blue light in the treatment of pathological neonatal jaundice has good clinical effect and the neonatal prognosis is good.The clinical efficacy of intermittent blue light irradiation is better,which can significantly shorten the treatment time and has higher safety.