邹洪波

[摘要] 目的 分析比較多次间歇与持续性冷光源蓝光照射治疗新生儿黄疸的效果。 方法 将150例足月分娩的新生儿伴病理性黄疸患儿作为研究对象，根据光源照射方式分为观察组（n=73）和对照组（n=77）；两组患儿均接受常规药物治疗及对症治疗，对照组采用持续性冷光源蓝光照射治疗，观察组采用多次间歇冷光源蓝光照射治疗；检测治疗前后血清总胆红素（TBIL）及直接胆红素（DBIL）浓度，评价治疗效果并记录治疗期间不良反应的发生情况。 结果 两组患儿治疗前TBIL、DBIL浓度比较差异无统计学意义（P>0.05）；治疗后两组TBIL、DBIL浓度均较治疗前显著降低，且观察组治疗后TBIL、DBIL浓度显著低于对照组，差异均具有统计学意义（P<0.05）；对照组治疗有效率为90.9%，观察组治疗有效率为95.9%，两组比较差异无统计学意义（P>0.05）；观察组患儿治疗期间不良反应发生率为13.7%，对照组不良反应发生率为32.5%，观察组显著低于对照组（P<0.05）。 结论 两种蓝光照射方式均具有良好的临床治疗效果，临床疗效相近的情况下对患儿进行间歇蓝光照射治疗，可有效降低患儿体内胆红素浓度及不良反应发生几率，提高患儿治疗效果以及生存质量，值得临床推广应用。

[关键词] 新生儿黄疸；冷光源；蓝光照射；照射时间

[中图分类号] R722.17 [文献标识码] A [文章编号] 2095-0616（2017）08-73-03

[Abstract] Objective To analyze and compare the efficacy of repeated intermittent and continuous cold light source blue light irradiation in the treatment of neonatal jaundice. Methods 150 cases of full-term delivery of newborns with disease of jaundice were selected as research objects.They were divided into observation group （n=73） and control group （n=77） according to the light source.All the patients in the two groups were treated with conventional drug therapy and symptomatic treatment.Patients in control group were treated with continuous cold light source blue light irradiation，and patients in observation group were treated with multiple intermittent cold light source.The levels of serum total bilirubin （TBIL） and direct bilirubin （DBIL） were detected before and after treatment，and the therapeutic effect was evaluated and adverse reactions were recorded during treatment. Results There was no significant difference between the two groups in TBIL and DBIL before treatment （P>0.05）.After treatment，TBIL，DBIL concentrations of the two groups were significantly lower than before treatment，and the TBIL，DBIL concentration of observation group were significantly lower than those of control group after treatment，and the difference was statistically significant （P<0.05）.The effective rate of the control group was 90.9%，the effective rate of the observation group was 95.9%，there was no significant difference between the two groups （P>0.05）.The incidence of adverse reactions in observation group was 13.7%，in control group 32.5%，the difference was significantly of two groups （P<0.05）. Conclusion Two kinds of blue light irradiation have good clinical effect.While the clinical curative effect is similar，intermittent phototherapy can effectively reduce the bilirubin concentration and the chance of adverse events in children，canand improve treatment outcomes and life quality.It is worthy of clinical application.

[Key words] Neonatal jaundice；Cold light source；Blue light irradiation；Irradiation time

新生儿黄疸是儿科最常见的疾病之一，其病因主要是新生儿血液中胆红素浓度异常升高而导致的皮肤、巩膜及黏膜黄染的现象，严重患儿可出现核黄疸，甚至出现脑神经功能损伤导致患儿残疾甚至死亡，严重威胁新生儿身体健康及生命安全[1]。因此，及时降低新生儿血液中的胆红素浓度，消退黄疸对新生儿健康具有重要的意义[2]。临床治疗新生儿黄疸常采用药物治疗和蓝光照射治疗，蓝光照射可以通过将间接胆红素转化为无毒水溶性衍生物，达到降低新生儿血液胆红素浓度的目的[3]。冷……