酪酸梭菌二联活菌联合苯巴比妥结合蓝光治疗早期新生儿高胆红素血症疗效评估

The clinical effect of combined clostridium butyricumand bifidobacterium and phenobarbital combined with blue light in the treatment of neonatal hyperbilirubinemia

目的观察酪酸梭菌二联活菌联合苯巴比妥结合蓝光治疗在早期新生儿高胆红素血症中的疗效,探讨其是否更优于其各自单独联合光疗的治疗效果。方法收集2018年12月至2019年7月间在皖南医学院弋矶山医院新生儿科收治的确诊为新生儿高胆红素血症需要光疗的病儿150例,通过随机数字表法分为试验组:酪酸梭菌二联活联合苯巴比妥结合光疗组,对照组:苯巴比妥结合光疗组(苯巴比妥组)及酪酸梭菌二联活菌结合光疗组(常乐康组),每组各50例。疗程5~7 d。分别观察各组中病儿经皮胆红素值的水平变化。结果治疗第3天苯巴比妥组经皮胆红素为(177.2±35.1)μmol/L,常乐康组为(176.6±34.0)μmol/L,试验组为(178.7±46.9)μmol/L,差异无统计学意义(F=0.033,P=0.967);治疗第5天苯巴比妥组经皮胆红素为(136.1±39.0)μmol/L,常乐康组为(136.1±38.3)μmol/L,试验组为(112.3±38.6)μmol/L,差异有统计学意义(F=5.367,P=0.006);治疗第7天苯巴比妥组经皮胆红素为(131.2±21.0)μmol/L,常乐康组为(127.4±23.9)μmol/L,试验组为(108.1±34.7)μmol/L,差异有统计学意义(F=3.394,P=0.036),其中试验组降低胆红素的疗效明显优于两个对照组。试验组光疗的不良反应总发生率明显低于两个对照组(P<0.05),疗效明显优于两个对照组(P<0.05)。结论酪酸梭菌二联活菌联合苯巴比妥结合蓝光治疗在早期新生儿高胆红素血症中的疗效肯定,更优于其各自单独联合光疗的治疗效果。

Objective To investigate the effect of combined clostridium butyricumand bifidobacterium and phenobarbital combined with blue light in the treatment of neonatal hyperbilirubinemia,and explore whether it is better than the respective combination of phototherapy.Methods By random number table method,150 neonates with neonatal hyperbilirubinemia admitted to Yijishan Hospital of Wannan Medical College from December 2018 to July 2019 were randomly divided into the experimental group:combined clostridium bifidobacterium and phenobarbital combined with blue light group,and control groups:combined clostridium butyri⁃cumand bifidobacterium combined with blue light group(Changlekang group)and phenobarbital combined with blue light group(phenobarbital group),with 50 cases in each group.The course of treatment is generally 5⁃7 days.The bilirubin levels were com⁃pared among the three groups after treatment.Results On the third day of treatment,the bilirubin level was(177.2±35.1)μmol/L in the phenobarbital group,(176.6±34.0)μmol/L in the Changlekang group,and(178.7±46.9)μmol/L in the experimental group,with no significant difference(F=0.033,P=0.967);on the 5th day of treatment,the bilirubin level was(136.1±39.0)μmol/L in the phenobarbital group,(136.1±38.3)μmol/L in the Changlekang group,(112.3±38.6)μmol/L in the experimental group,and the difference was statistically significant(F=5.367,P=0.006);on the 7th day of treatment,the bilirubin level was(131.2±21.0)mg/dL in the phenobarbital group,(127.4±23.9)μmol/L in th Changlekang group,(108.1±34.7)μmol/L in th experimental group,and the difference is statistically significant(F=3.394,P=0.036).The effect of reducing bilirubin in the experimental group was signif⁃icantly better than that of the two control groups.The total incidence of adverse reactions of phototherapy in the experimental group was significantly lower than that of the two control groups(P<0.05),and the curative effect was significantly better than that of the two control groups(P<0.05).Conclusion Combined clostridium butyricumand bifidobacterium and phenobarbital combined with blue light in treatment of neonatal hyperbilirubinemia has significant curative effect,which is better than their respective com⁃bined with light therapy alone.