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早期不同蓝光照射方案治疗新生儿黄疸的效果及安全性观察

Effects and Safety of Different Blue Light Irradiation Regimens in the Treatment of Early Neonatal Jaundice
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摘要 目的观察早期不同蓝光照射方案治疗新生儿黄疸的效果及安全性。方法选取2017年1月—2018年1月遂宁市中心医院收治的126例病理性黄疸患儿,采用随机数字表法分为研究组和对照组各63例。研究组在常规治疗基础上加用间歇蓝光照射,每次4h,每日4次,每次照射后间歇2h,连续应用3d;对照组在常规治疗基础上加用持续蓝光照射,每次16h,每日1次,连续应用3d。治疗3d后评估两组临床疗效;比较治疗前、治疗3d后两组患儿血清和粪便胆红素水平,血清降钙素原(PCT)、胱抑素C(CysC)、白细胞介素-6(IL-6)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平;并观察两组治疗期间不良反应发生情况。结果治疗3d后两组总有效率比较差异无统计学意义(P>0.05)。治疗3d后,两组血清胆红素水平均较治疗前降低,粪便胆红素水平均较治疗前升高,差异均有统计学意义(P<0.01);两组治疗前、治疗3d后血清和粪便胆红素水平比较差异无统计学意义(P>0.05)。治疗3d后,两组血清PCT、CysC、IL-6水平均较治疗前降低,且研究组血清PCT、CysC、IL-6水平低于对照组,差异均有统计学意义(P<0.01)。治疗3d后,两组血清MDA水平较治疗前升高,血清SOD水平较治疗前降低,且研究组血清MDA升高和SOD降低程度均小于对照组,差异均有统计学意义(P<0.05或P<0.01)。治疗期间研究组总不良反应发生率为9.52%低于对照组的26.98%,差异有统计学意义(P<0.05)。结论间歇蓝光照射治疗新生儿黄疸安全、有效,在降低不良反应发生率、减轻炎性反应方面更具优势,且对患儿氧化应激状态影响较小,有利于患儿康复。 Objective To observe the effects and safety of different blue light irradiation regimens in the treatment of early neonatal jaundice.Methods A total of 126 children patients with pathological jaundice who were treated in Suining Central Hospital from January 2017 to January 2018 were selected for the study.Then they were divided into research group(n=63)and control group(n=63)according to the random number table method.On the basis of conventional treatment,the research group was treated with intermittent blue light 4 times a day,4 h each time,with 2 h interval after each irradiation,which was applied continuously for 3 days.The control group was treated with continuous blue light once a day,16 h each time,for 3 consecutive days.The efficacy of both groups was evaluated 3 d after treatment,and the serum and fecal bilirubin levels,serum procalcitonin(PCT),cystatin C(CysC),interleukin-6(IL-6)and malonaldehyde(MDA)and superoxide dismutase(SOD)were measured before treatment(T1)and 3d after treatment(T2)in the two groups,and the adverse reactions during treatment were observed in both groups.Results There was no significant difference in total effective rate between the 2 groups 3 d after treatment(P>0.05).After 3 days of treatment,serum bilirubin levels were lower than those before treatment,while fecal bilirubin levels were higher than those before treatment(P<0.01).There was no significant difference in the serum and fecal bilirubin levels between the two groups before treatment and 3 d after treatment(P>0.05).After 3 d of treatment,the levels of serum PCT,CysC and IL-6 in both groups were lower than those before treatment,and the serum levels of PCT,CysC and IL-6 in the research group were lower than those in the control group(P<0.01).After 3 d of treatment,serum MDA levels in the two groups were higher but serum SOD levels were lower,as compared with those before treatment in both groups.An increase in serum MDA and a decrease in SOD in the research group were superior to those in the control group(P<0.05 or P<0.
作者 冉珊 沈聃 RAN Shan;SHEN Dan(Pediatric Rehabilitation Ward, the Central Hospital of Suining, Suining, Sichuan 629000, China;Department of Pediatrics, the Third People's Hospital of Chengdu, Chengdu 610000, China)
出处 《临床误诊误治》 2019年第1期90-94,共5页 Clinical Misdiagnosis & Mistherapy
基金 四川省卫计委科研课题资助项目(12022).
关键词 光疗法 黄疸 新生儿 氧化应激 治疗结果 Phototherapy Jaundice,neonatal Oxidative stress Treatment outcome
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