静脉滴注人血丙种球蛋白联合光疗治疗新生儿溶血性黄疸的临床效果

Clinical effect of intravenous human gamma globulin combined with phototherapy in the treatment of neonatal hemolytic jaundice

目的探讨静脉滴注人血丙种球蛋白联合光疗治疗新生儿溶血性黄疸的临床效果。方法选取2018年12月—2020年12月湖州市妇幼保健院收治的79例新生儿溶血性黄疸患儿为研究对象,采用随机数字表法分为对照组(39例)和观察组(40例),对照组患儿接受蓝光治疗,观察组患儿接受人血丙种球蛋白联合蓝光治疗。比较两组患儿临床疗效、临床指标、血清学指标水平[总胆红素(TBIL)、血红蛋白(Hb)及红细胞计数(RBC)]及不良反应。结果观察组患儿黄疸消退时间、胎便转黄时间及住院时间[(5.32±1.94)d、(49.15±15.32)h及(4.92±0.83)h]均短于对照组[(7.63±2.11)d、(58.69±19.86)h及(6.85±1.26)h],差异均有统计学意义(t=5.068、2.394及8.059,均P<0.05)。治疗后,两组患儿TBIL水平均下降,且观察组患儿TBIL水平[(75.85±4.41)μmol/L]低于对照组[(90.24±5.83)μmol/L],差异有统计学意义(t=12.393,P<0.05)。治疗前和治疗后,两组患儿Hb水平[治疗前观察组(144.53±5.41)g/L,对照组(143.96±5.46)g/L;治疗后观察组(142.87±5.39)g/L,对照组(142.79±5.42)g/L]和RBC水平[治疗前观察组(4.33±0.29)g/L,对照组(4.36±0.31)g/L;治疗后观察组(4.27±0.26)g/L,对照组(4.24±0.29)g/L]比较,差异均无统计学意义(t=0.466、0.066、0.444及0.484,均P>0.05)。两组患儿不良反应总发生率比较(观察组10.00%,对照组7.69%),差异无统计学意义(χ^(2)=0.001,P>0.05)。结论静脉滴注人血丙种球蛋白联合光疗治疗新生儿溶血性黄疸可有效降低患儿血清TBIL水平,改善患儿临床症状,有利于缩短患儿住院时间,安全性较高。

Objective To explore the clinical effect of intravenous human gamma globulin combined with phototherapy in the treatment of neonatal hemolytic jaundice.Methods Select 79 newborns with hemolytic jaundice admitted to Huzhou Maternal and Child Health Hospital from December 2018 to December 2020 as the study subjects,and divide them into control group(39 cases)and observation group(40 cases)by random number table method.Children in the control group received blue light treatment,and children in the observation group received human gamma globulin combined with blue light treatment.The clinical efficacy,clinical indexes,serum index levels[total bilirubin(TBIL),hemoglobin(Hb)and erythrocyte count(RBC)]and adverse reactions were compared between the two groups.Results The time of jaundice regression,the time of turning yellow of fetal stool and the time of hospitalization in the observation group[(5.32±1.94)d,(449.15±15.32)h and(4.92±0.83)h]were shorter than those in the control group[(7.63±2.11)d,(58.69±19.86)h and(6.85±1.26)h],and the difference were statistically significant(t=5.068,2.394 and 8.059,all P<0.05).After treatment,the TBIL level of children in both groups decreased,and the TBIL level of children in the observation group[(75.85±4.41)μmol/L]is lower than that of the control group[(90.24±5.83)μmol/L],the difference was statistically significant(t=12.393,P<0.05).Before and after treatment,the levels of Hb in the two groups[observation group before treatment(144.53±5.41)g/L,control group(143.96±5.46)g/L;observation group after treatment(142.87±5.39)g/L,control group(142.79±5.42)g/L]and RBC[observation group before treatment(4.33±0.29)g/L,control group(4.36±0.31)g/L;observation group after treatment(4.27±0.26)g/L,control group(4.24±0.29)g/L]were compared,The difference was not statistically significant(t=0.466,0.066,0.444 and 0.484,all P>0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(10.00%in the observation group and 7.69%in the control group)(χ^(2)=0.001,P>0.05).Conclusion Intravenous injection of human gamma globulin combined with phototherapy in the treatment of neonatal hemolytic jaundice can effectively reduce the serum TBIL level of children,improve the clinical symptoms of children,shorten the hospitalization time of children,and have high safety.