蓝光治疗对新生儿黄疸的临床治疗效果及其治疗后反弹的影响因素分析

The clinical effect of blue light therapy on neonatal jaundice and the influencing factors of rebound after treatment

目的探讨蓝光治疗在新生儿黄疸中的临床效果,并分析其影响因素。方法100例新生儿黄疸患儿,均进行蓝光照射治疗。记录患儿治疗后新生儿黄疸反弹发生情况,并分析其影响因素。结果100例新生儿黄疸患儿,实施蓝光照射治疗后出现37例(37.00%)反弹。新生儿黄疸蓝光治疗后反弹患儿的剖宫产占比54.05%、新生儿ABO溶血病占比54.05%、治疗前红细胞比容<45%占比59.46%,与未反弹患儿的15.87%、31.75%、36.51%对比差异显著(P<0.05)。新生儿黄疸蓝光治疗后反弹与未反弹患儿的孕周、胎膜早破、妊娠期糖尿病、妊娠期高血压发生情况对比无差异(P>0.05)。Logistic回归分析显示,分娩方式、新生儿ABO溶血病、治疗前红细胞比容是蓝光治疗后新生儿黄疸反弹的影响因素(P<0.05)。结论新生儿蓝光治疗后出现反弹的原因包括剖宫产、合并新生儿ABO溶血病,治疗前红细胞比容较低等,所以在临床上使用蓝光治疗时,必须采取有针对性的措施,减少蓝光治疗后反弹的几率。

Objective To investigate the clinical effect of blue light therapy in neonatal jaundice,and analyze its influencing factors.Methods 100 cases of neonatal jaundice were treated with blue light irradiation.The rebound of neonatal jaundice after blue light irradiation was recorded,and its influencing factors were analyzed.Results In 100 neonates with jaundice,37 rebounded cases(37.00%)occurred after implementation of blue light therapy.After blue light therapy for neonatal jaundice,the percentage of cesarean section,neonatal ABO hemolytic disease,and pre-treatment hematocrit<45%of the rebounded neonates were 54.05%,54.05%and 59.46%,and there was significant difference when compared with 15.87%,31.75%,and 36.51%of the non-rebounded neonates(P<0.05).After blue light therapy for neonatal jaundice,there was no difference in the comparison of gestational weeks,premature rupture of membranes,gestational diabetes mellitus,and the occurrence of gestational hypertension between the rebounded neonates and the non-rebounded neonates(P>0.05).Logistic regression analysis showed that mode of delivery,neonatal ABO hemolytic disease,and pre-treatment hematocrit were the factors influencing the rebound of neonatal jaundice after blue light therapy(P<0.05).Conclusion Reasons for rebound of neonatal jaundice after blue light therapy include cesarean delivery,combination of neonatal ABO hemolytic disease,and low pre-treatment hematocrit,etc.Therefore,when using blue light therapy in the clinic,it is important to take targeted measures to reduce the chances of rebound after blue light therapy.