布拉酵母菌、苯巴比妥结合蓝光治疗新生儿高胆红素血症对胆红素水平及神经系统的影响

Effect of Saccharomyces boulardii,phenobarbital combined with blue light in the treatment of neonatal hyperbilirubinemia on bilirubin levels and nervous system

目的探讨布拉酵母菌、苯巴比妥结合蓝光治疗新生儿高胆红素血症(NHB)对胆红素水平及神经系统的影响。方法抽取2017年1月至2019年12月收治的新乡医学院第三附属医院NHB患儿98例,依据随机表法分为观察组49例与对照组49例。两组患儿均给予蓝光治疗,对照组给予布拉酵母菌散治疗,观察组在对照组基础上给予苯巴比妥治疗。两组患儿疗程均为7 d。比较两组患儿治疗疗效和黄疸消退时间;比较两组治疗前后胆红素水平、神经元特异性烯醇化酶(NSE)和神经肽(NPY)水平变化及不良反应发生情况。结果观察组治疗总有效率(95.92%)高于对照组(79.59%),P<0.05。观察组黄疸消退时间短于对照组(P<0.05)。两组治疗后经皮胆红素和血清胆红素水平低于治疗前(P<0.05);观察组治疗后经皮胆红素和血清胆红素水平低于对照组(P<0.05)。两组治疗后血清NSE和NPY水平低于治疗前(P<0.05);观察组治疗后血清NSE和NPY水平低于对照组(P<0.05)。两组不良反应比较,P>0.05。结论布拉酵母菌、苯巴比妥结合蓝光治疗NHB患儿疗效良好,可降低胆红素水平,改善患儿神经系统,且不良反应少,安全性良好。

Objective To investigate the effects of Saccharomyces boulardii,phenobarbital and blue light in the treatment of neonatal hyperbiliru binemia(NHB)on the level of bilirubin and the nervous system.Methods A total of 98 children with NHB in the Third Affiliated Hospital of Xinxiang Medical College from January 2017 to December 2019 were selected,and divided into observation group of 49 cases and control group of 49 cases according to the random table method.Both groups were given blue light therapy,the children in the control group were treated with Saccharomyces boulardii powder,and the children in the observation group were treated with phenobarbital on the basis of the control group.The course of treatment for both groups was 7 days.The therapeutic effects and time of jaundice resolution were compared between the two groups of children;the changes of bilirubin levels,neuron-specific enolase(NSE)and neuropeptide(NPY)levels before and after treatment,and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate(95.92%)in the observation group was higher than 79.59%of the control group(P<0.05).The jaundice subsidence time in the observation group of the shorter than that in the control group(P<0.05).The levels of percutaneous bilirubin and serum bilirubin of the two group after treatment were lower than those before treatment(P<0.05);the levels of transcutaneous bilirubin and serum bilirubin of the two group after treatment in the observation group were lower than those in the control group(P<0.05).After treatment,the serum NSE and NPY levels of the two group were lower than those before treatment(P<0.05);after treatment,the levels of serum NSE and NPY in the observation group were lower than those in the control group(P<0.05).Comparison of adverse reactions between the two groups(P>0.05).Conclusions Saccharomyces boulardii,phenobarbital and blue light are effective in the treatment of children with NHB,which can reduce the level of bilirubin and improve the nervous system of children with less adverse reactions and good safety.