刘翼昌+黄彬+邱文

摘 要 目的：觀察蓝光联合茵栀黄治疗新生儿病理性黄疸的效果。方法：收集2014年10月—2016年8月儿科收治的新生儿病理性黄疸患儿100例，随机分为治疗组和对照组各50例。两组均实施常规对症治疗，同时对照组给予蓝光治疗，治疗组给予蓝光和茵栀黄治疗。记录两组疗效、不良反应、黄疸消退时间以及血清胆红素水平。结果：治疗组总有效率为92.0%（46/50），高于对照组的72.0%（36/50，P<0.05）。治疗后两组血清胆红素含量均较治疗前下降，治疗组较对照组更为显著（P<0.05）。治疗组患儿黄疸平均消退时间为（4.01±0.83）d，对照组为（5.91±1.01）d，组间差异有统计学意义（P<0.05）。治疗前后两组肝肾功能、血常规及尿常规检查均无显著变化，且均无严重不良反应。结论：蓝光联合茵栀黄治疗新生儿病理性黄疸疗效显著，且不良反应少，安全可靠，值得临床应用和推广。

关键词 病理性黄疸；茵栀黄；新生儿；蓝光

中图分类号：R722.17 文献标志码：A 文章编号：1006-1533（2017）18-0036-02

Therapeutic effect of blue light combined with Yinzhihuang in the treatment of neonatal pathological jaundice

LIU Yichang， HUANG Bin， QIU Wen

（Neonatal Department of the First Peoples Hospital of Nankang District， Ganzhou 341400， Jiangxi Province， China）

ABSTRACT Objective： To observe the therapeutic effect of blue light combined with Yinzhihuang in the treatment of neonatal pathological jaundice. Methods： From October 2014 to August 2016， 100 cases of pathological neonatal jaundice in the Department of Pediatrics were collected， a n d randomly divided into a treatment group and a control group with 50 cases in each group. The two groups were treated with conventional symptomatic treatment， while the control group was given blue light treatment， and the treatment group was given blue light and Yinzhihuang treatment. The therapeutic effect， adverse reaction， jaundice extinction time and serum bilirubin level of the two groups were recorded. Results： The total effective rate of the treatment group was 92%（46/50）， which was higher than that of the control group 72%（36/50， P<0.05）. After treatment， serum bilirubin levels of the two groups were lower than those before treatment， and the treatment group was more significant than the control group（P<0.05）. The average regression time of jaundice in the treatment group was （4.01±0.83） d， that in t he control group was （5.91±1.01） d， and the difference between the two groups was statistically significant（P<0.05）. There were no significant changes in liver and kidney function， routine blood test and urine routine examination before and after treatment， and there were no serious adverse reactions in the two groups. Conclusion： The therapeutic effect of Yinzhihuang combined with blue light in the treatment of neonatal pathological jaundice is remarkable， and adverse reactions are less， it is safe and reliable. It is worthy of clinical application and popularization.

KEY WORD pathologic jaundice； Yinzhihuang； neonate； blue lighendprint

新生儿溶血病、感染、缺氧、红细胞酶缺乏以及酸中毒等均有可能使新生儿胆红素异常上升，出现病理性黄疸，因患儿脑屏障尚未发育成熟，间接胆红素升高可经血脑屏障聚积于脑组织，引起胆红素脑病，影响患儿生长发育，严重时还会威胁患儿生命[1-3]。目前，在新生儿病理性黄疸的临床治疗中，蓝光治疗作为常用方式效果确切，但长期蓝光治疗容易使患儿出现各种不良反应，如发热、腹泻及贫血等，因此一般推荐以间断性方式实施蓝光治疗[4-5]。茵栀黄主要由茵陈、黄芩及栀子构成，保肝利湿退黄功效显著[6-7]。本文报道联合应用蓝光和茵栀黄治疗新生儿病理性黄疸的效果。

1 资料与方法

1.1 一般资料

收集2014年10月—2016年8月儿科收治的新生儿病理性黄疸患儿100例，均符合2005年中华医学会制定的新生儿病理性黄疸诊断标准[8]。按照随机对照等分原则将100例患儿分成对照组和治疗组各50例。对照组中男性28例，女性22例，年龄3～14 d，平均（6.2±2.3）d，体重2.7～6.9 kg，平均（3.5±1.1）kg。……