光疗联合白蛋白治疗足月新生儿重度黄疸的效果观察与评价

彭志海 张望 叶剑武 黄玲 朱志刚

【摘要】 目的：研究对重度黄疸的足月新生儿联合光疗及白蛋白治疗的临床效果与价值。方法：选择笔者所在医院新生儿科重度黄疸足月新生儿60例，将其随机分为观察组与对照组，每组30例。对照组应用蓝光灯照射治疗，观察组在此基础上联合白蛋白治疗。比较两组患儿血清直接胆红素（DBIL）、间接胆红素（IBIL）、总胆红素（TBIL）水平及不良反应发生情况。结果：治疗前两组血清胆红素指标比较差异均无统计学意义（P>0.05）;治疗后观察组各项胆红素指标均显著低于对照组，差异均有统计学意义（P<0.05）。观察组不良反应发生率低于对照组，但两组比较差异无统计学意义（P>0.05）。结论：对重度黄疸新生儿联合光疗与白蛋白治疗可快速降低胆红素水平，并发症发生率低，治疗安全可靠，对促进新生儿黄疸消退及促进预后恢复均具有积极意义。

【关键词】 蓝光光疗 白蛋白 足月新生儿 重度黄疸

doi：10.14033/j.cnki.cfmr.2019.30.071 文献标识码 B 文章编号 1674-6805（2019）30-0-03

[Abstract] Objective： To assess the clinical effect and value of phototherapy plus albumin in full-term newborns with severe jaundice. Method： A total of 60 full-term newborns with severe jaundice in the neonatal department of our hospital were selected and randomly divided into the observation group and the control group， 30 cases in each group. The control group was treated with blue light irradiation， while the observation group was treated with albumin on this basis. The levels of serum direct bilirubin （DBIL）， indirect bilirubin （IBIL） and total bilirubin （TBIL） and adverse reactions were compared between the two groups. Result： Before treatment， there were no significant differences in serum bilirubin indexes between the two groups （P>0.05）. After treatment， the serum bilirubin indexes in the observation group were significantly lower than those of the control group， the differences were statistically significant （P<0.05）. The incidence of adverse reactions in the observation group was lower than that in the control group， but the difference between the two groups was not statistically significant （P<0.05）. Conclusion： The combination of phototherapy and albumin for severe jaundice neonates can rapidly reduce serum bilirubin level， and reduce the incidence of complications， the treatment is safe and reliable. It has positive significance for promoting the regression of jaundice and recovery of prognosis.

[Key words] Phototherapy Albumin Full-term newborn Severe jaundice

First-authors address： Luhe County Peoples Hospital， Luhe 516700， China

新生儿黄疸是新生儿常见病之一，由于受到各类因素影响导致婴儿出生后出现胆红素代谢异常，血清中胆红素量增加从而导致新生儿出现皮肤、黏膜、巩膜黄染等症状[1-2]。新生儿黄疸主要以生理性黄疸与病理性黃疸为主。前者属于正常生理现象可在新生儿出生后自行消退，后者为病理性改变，若不及时治疗可能进一步导致胆红素增加而影响脑组织与神经功能的正常发育，造成脑组织损伤、神经系统瘫痪等[3]。及时控制体内胆红素水平、改善黄疸症状是目前临床治疗的主要目的[4]。本研究为探讨光疗联合白蛋白治疗足月新生儿重度黄疸的临床效果与意义，特选取60例本病患儿临床资料进行分析，现报道如下。