基于微视频的健康教育对日间光疗室黄疸新生儿照顾者负性情绪的影响

目的 探讨基于微视频的健康教育对日间光疗室黄疸新生儿照顾者负性情绪的影响.方法 选择2020年5-10月在日间光疗室治疗的59名黄疸新生儿照顾者作为对照组,2020年11月-2021年4月在日间光疗室治疗的59名黄疸新生儿照顾者作为观察组,对照组采用常规健康宣教,观察组在对照组基础上采用基于微视频的健康教育方法,比较2...     

Mechanisms and Pathways of Pain Photobiomodulation: A Narrative Review

A growing body of evidence supports the modulation of pain by light exposure. As such, phototherapy is being increasingly utilized for the management of a variety of pain conditions. The modes of delivery, and hence applications of phototherapy, vary by wavelength, intensity, and route of exposure. As such, differing mechanisms of action exist depending upon those parameters. Cutaneous application of red light (660 nm) has been shown to reduce pain in neuropathies and complex regional pain syndrome-I, whereas visual application of the same wavelength of red light has been reported to exacerbate migraine headache in patients and lead to the development of functional pain in animal models. Interestingly visual exposure to green light can result in reduction in pain in variety of pain conditions such as migraine and fibromyalgia. Cutaneous application typically requires exposure on the order of minutes, whereas visual application requires exposure on the order of hours. Both routes of exposure elicit changes centrally in the brainstem and spinal cord, and peripherally in the dorsal root ganglia and nociceptors. The mechanisms of photobiomodulation of pain presented in this review provide a foundation in furtherance of exploration of the utility of phototherapy as a tool in the management of pain.PerspectiveThis review synopsizes the pathways and mechanisms through which light modulates pain and the therapeutic utility of different colors and exposure modalities of light on pain. Recent advances in photobiomodulation provide a foundation for understanding this novel treatment for pain on which future translational and clinical studies can build upon.     

改良的蓝光光疗罩布临床应用效果观察

目的 探讨有效降低蓝光光疗操作时意外发生率和缩短NICU护士实施蓝光光疗操作耗时的方法.方法 随机选取2015年3~6月住院接受蓝光治疗的160例患儿作为研究对象,将上述患儿随机分为两组,对照组(80例)采用传统的蓝光光疗罩布进行蓝光治疗,试验组(80例)采用改良的蓝光光疗罩布进行蓝光治疗.结果 试验组实施蓝光治疗操作时意外发生率为0.6%,低于对照组的2.6%;试验组患儿完成光疗平均耗时(315.12±144.65)s,短于对照组的(465.62±241.02)s;护理人员对改良的蓝光光疗罩布的满意度高于传统的光疗罩布,差异均有统计学意义(P＜0.05).结论 改良的蓝光光疗罩布能有效降低蓝光光疗操作时意外发生率,缩短日平均护理时数,有效提高NICU护士的工作效率及满意度.     

Photocatabolism of labeled bilirubin in the congenitally jaundiced (Gunn) rat

To elucidate the mechanism by which phototherapy reduces serum bilirubin, studies were performed on the catabolism of labeled bilirubin in homozygous jaundiced Gunn rats before, during, and after a period of exposure to 1700 foot candles of daylight fluorescent light. Following equilibration with the body pool of an intravenously administered tracer dose of (3)H- or (14)C-bilirubin, radioactive and diazo reactive compounds were excreted in the bile at a slow, steady rate and plasma specific activity declined semilogarithmically. Subsequent exposure to light caused a marked increase in the biliary excretion of radioactive and diazoreactive compounds. Fecal and urinary radioactivity increased also but remained minor fractions of the total excreted radioactivity. After extinguishing the lights, these variables reverted gradually to control values. Spectral and chromotographic analysis of the excreted pigments and their azopigments demonstrated that the increased biliary radioactivity during phototherapy consisted of two roughly equal fractions: (a) unconjugated bilirubin, excreted at rates comparable to the output of conjugated bilirubin in the bile of normal nonjaundiced rats; and (b) water-soluble bilirubin derivatives, chromatographically identical with those found in Gunn rat bile under control lighting conditions but different from the products of photodecomposition of bilirubin in vitro. In some animals, phototherapy produced little decline in plasma bilirubin despite comparable acceleration of bilirubin catabolism. This was attributed tentatively to increased synthesis of early labeled bilirubin in these animals.     

蓝光照射对于新生儿高胆红素血症的临床疗效

目的探讨蓝光照射对于新生儿高胆红素血症患者的治疗效果,评价其临床价值。方法对于2010年12月至2011年12月治疗的64例新生儿高胆红素血症患者,随机分为两组,对照组患者给予苯巴比妥,观察组患者给予蓝光照射治疗（A组给予持续性蓝光照射,B组给予间歇性蓝光照射）,对两组患者的有效率、退黄效果、胆红素下降程度及疗程进行比较。结果观察组患者治疗有效率为90．6％（29／32）,对照组患者治疗有效率为71．8％（23／32）,观察组有效率高于对照组（P〈0．05）;观察组患者的胆红素下降速度快于对照组,黄疸减退时间均短于对照组（P〈0．05）;观察组患者的疗程短于对照组,间歇性照射效果好于持续照射,两组间差异具有统计学意义（P〈0．05）。结论蓝光治疗对于新生儿高胆红素血症患者的治疗效果较好,能够提高患者的有效率,促进胆红素下降及黄疸消退,间歇性蓝光照射效果好于持续性照射,具有很好的临床应用价值。     

Photodynamic therapy: another option in cancer treatment

Photodynamic therapy (PDT)--also called phototherapy, photoradiation therapy, or photochemotherapy--is a relatively new treatment option being used to treat certain types of cancer, including endobronchial and esophageal cancers. PDT is a two-step process that involves administration of a photosensitizing agent followed by exposure to non thermal laser light. Intensive patient education and support are required during PDT. In the immediate post-procedure period, patients require intensive monitoring to ensure that a patient airway is maintained and pain is alleviated. Photosensitivity persist for four to six weeks post-PDT; to avoid photosensitivity reactions, patients must adhere to specific recommendations to avoid exposure to light. PDT is noted for extending the life expectancy and improving the quality of life of patients.     

新生儿高未结合胆红素血症的光疗研究护理进展

目的介绍光疗的研究进展,并解决光疗过程中存在的护理问题,以提高疗效,减少副作用。方法参考国内外相关文献,对光源的发展及光疗的方法进行综合分析、比较、归纳。结果光源的种类较多,方法多样。光源由传统的日光、冷白光、日光灯、蓝光灯、卤灯发展到近几年推出的绿光、蓝光发光二极管等;方法有双面蓝光箱、单面蓝光治疗仪、光纤毯、蓝光毯、蓝光床、蓝光发光二极管等。讨论临床上应严格掌握光疗指针,根据病情选择光疗方式。普遍认为双面蓝光箱比单面蓝光治疗仪效果好,蓝光箱比蓝光毯光照效果好,而蓝光加绿光效果最佳。为了提高疗效,减少副作用,光疗过程中要注意保护患儿眼睛及外生殖器;保持皮肤清洁、完整,防止感染;维持体温的恒定;维持水、电解质平衡等。     

Effect of Bright Light Exposure on Depression and Agitation in Older Adults with Dementia

This study examined the effects of bright light exposure on three measures of depression and four measures of agitation in persons with dementia residing in long-term care. Using a randomized controlled design, participants were randomly assigned to receive either bright light (n = 30) or low intensity light (n = 30) for eight weeks. Bright light exposure was associated with significant improvement in depression and agitation, while participants receiving low intensity light displayed higher levels of depression and agitation or no significant change. Findings support the use of bright light exposure to reduce depression and agitation in this population.     

An evaluation of the characteristics and performance of neonatal phototherapy equipment

This paper reviews the current state of knowledge and practice in neonatal phototherapy, and assesses methods of evaluating the characteristics and performance of different equipment. Artificial lighting (usually fluorescent) has been used for the past 30 years in the treatment of neonatal jaundice. Widely differing light outputs and spectra are used, making comparison and evaluation difficult for clinicians. Manufacturers of neonatal phototherapy equipment have no standard for assessing the performance of their equipment, and information that is supplied is at best confusing or deceptive to the users. Best practice is usually based on empirical data from equipment in use, but there is wide agreement that present phototherapy is sub-optimal, i.e. does not achieve maximum rate of bilirubin clearance for minimum therapeutic dose. Several studies in the last ten years have emphasized the importance of both the wavelength and intensity of light for optimal phototherapy. These are discussed and a technique is proposed for normalizing the output of different systems to make comparison easier and to enable optimal treatments to be designed.     

Phototherapy in the context of psychotherapy

Phototherapy, or treatment with bright artificial light, has been used to treat seasonal affective disorder and related conditions. Using the cases of two patients who were treated with both psychotherapy and phototherapy, the author explores the potentially powerful psychotherapeutic aspects of this new treatment. Within a therapeutic relationship, light has a rich symbolism, and it may serve as an inanimate symbol of the therapist. Perhaps because of the lack of well-established guidelines or traditions regarding its use within psychotherapy, however, light treatment can lead to the violation of the usual boundaries of treatment. If this danger is avoided, phototherapy may be a powerful adjunct to psychotherapy.     

The effect of home-based phototherapy on parental stress in mothers of infants with neonatal jaundice

Background

Hospitalization of an infant in the first days following birth is one of the most stressful events in the life of the parents of any parent. More than half of the infants suffer from neonatal jaundice, and are referred to health centers by their parents for treatment. In wake of this, the present study aims to examine the effect of home-based phototherapy on parental stress in mothers of infants with neonatal jaundice.

Hepatic excretion of circulating bilirubin photoproducts in the Gunn rat.

To investigate the origin and metabolism of the intermediates that occur in blood during phototherapy of neonatal jaundice, serum from irradiated homozygous Gunn rats was injected intravenously into other homozygous Gunn rats fitted with bile fistulas, and the excretion of pigment in the bile of the recipient rats was studied. In some experiments the donor rats were labeled with [14C]bilirubin; in others the recipient rats were labeled. Injection of donor serum from irradiated rats caused a transient burst of pigment excretion in the bile of the recipient rats. However, simultaneous bursts of pigment and 14C excretion were observed only when the donor rat was labeled and the recipient rat was not, and not when the donor rat was unlabeled and the recipient rat was labeled. In addition, there was simultaneous transient enhanced excretion of pigment and label when labeled recipient rats were exposed briefly to blue light. We conclude that (a) the phototherapy intermediates previously detected spectroscopically in serum are formed from bilirubin and are excreted in bile independently of bilirubin; (b) the enhanced excretion of pigment in bile during phototherapy is not caused by complex formation between bilirubin and photoproducts, or by liver damage produced by photoproducts or light.     

2种不同时间蓝光照射法对新生儿高胆红素血症的影响

目的探讨两种不同时间蓝光照射法对新生儿高胆红素血症的效果。方法将130例高胆红素血症新生儿随机分为对照组和观察组,每组65例,分别采用持续蓝光照射法和间歇蓝光照射法。比较两组患儿退黄效果、每天胆红素下降幅度和疗程。结果两组患儿退黄效果、每天胆红素下降幅度、疗程比较,经统计学分析,均P>0.05,差异无统计学意义。结论间歇蓝光照射治疗新生儿高胆红素血症疗效满意,提高患儿心理上的满足与身体的舒适。     

不同眼罩摘除方法对光疗新生儿舒适度的影响

目的 探讨光疗新生儿摘除眼罩时应用遮光布罩盖暖箱对新生儿舒适度的影响.方法 将高间接胆红素血症新生儿70例按住院号尾数的单双数分为两组,每组35例.干预组新生儿蓝光治疗后放置于罩盖有遮光布的暖箱中,待安静时摘除眼罩,并逐步撤去遮光布;对照组新生儿置于日常光线环境下的暖箱中,待安静时直接摘除眼罩.观察两组新生儿面部表情、心率、经皮血氧饱和度(SpO2)的变化.结果 摘除眼罩时干预组新生儿面部表情无明显变化,心率、SpO2波动小,两组比较差异有统计学意义(P＜0.05).结论 光疗新生儿摘除眼罩时应用遮光布罩盖暖箱可提高新生儿舒适度.     

两种干预对高胆红素血症新生儿情绪和睡眠的影响

[目的]探讨两种干预对高胆红素血症新生儿情绪和睡眠时间的影响。[方法]将68例高胆红素血症新生儿随机分为A组和B组,A组按常规治疗护理,间断蓝光照射48h,分4d进行,B组在A组基础上施以抚触,每天2次,每次15min,分别于光疗初期及后期进行,观察两组患儿4d内哭闹及睡眠情况。[结果]B组哭闹次数明显少于A组,每日睡眠时间明显多于A组。[结论]常规干预加抚触有利于稳定患儿的情绪,提高睡眠质量。     

Seasonal affective disorder: its recognition and treatment

This article provides an introduction to seasonal affective disorder (SAD) and outlines various therapies, including phototherapy (light therapy), used in its treatment. SAD, colloquially termed 'winter blues', is a common condition that is thought to be caused by reduced levels of daylight in winter. During this period sufferers generally feel low and may experience clinical depression. The Department of Psychiatry at the University of Southampton has an established SAD service as part of its mood disorders clinic, which was developed from a research-based clinical investigation unit set up in the early 1990s. SAD is described as a mood disorder with a seasonal pattern and has a greater prevalence in countries with greater northern latitude. The aetiology of SAD is unclear, although the most promising theory suggests the role of the neurotransmitter serotonin. SAD is difficult to treat with conventional antidepressants although there is evidence that serotonin selective reuptake inhibitors may be useful for some patients. Phototherapy (light therapy) has been used successfully by many patients although it remains controversial and difficult to obtain on the NHS.     

Bright Light Therapy to Treat Depression in Individuals with Mild/Moderate or Severe Dementia

ABSTRACT

This secondary analysis examined whether the benefits of bright light therapy on depression are greater in persons with mild/moderate or severe dementia. Exploratory analyses were also conducted to determine if bright light treatment targets different depressive symptom clusters based on dementia severity. Analyses using total scores from the instruments, Depressive Symptom Assessment for Older Adults and the Cornell Scale for Depression in Dementia, showed that bright light exposure is an equally effective intervention for depression in persons with both mild/moderate and severe dementia. Analyses of individual depressive subscales revealed that for disagreeable behavior and sleep impairment, bright light therapy appears to have greater benefits in persons with severe dementia than for those with mild/moderate dementia. Overall, this investigation supports the use of bright light therapy to treat depression regardless of dementia severity.     

尿毒症性皮肤瘙痒症治疗的研究进展

<正>尿毒症性皮肤瘙痒症(Uremic Pruritus,UP)是血液透析患者常见并发症之一。一项包含了17个国家的大规模流行病学研究[1]显示,2012～2015年UP患者占透析患者比率约为69%。UP与患者生活质量大幅下降、抑郁状态、睡眠质量降低和死亡率升高密切相关。UP为多种因素共同作用的结果,目前提出的相关假说主要包括皮肤干燥症、尿毒症毒素蓄积、免疫炎症假说、透析前β2微球蛋白水平升高、钙磷等离子紊乱、高水平的甲状旁腺激素及与UP发生相关的常见并发症,包括糖尿病、病毒性肝炎、内分泌紊乱、躯体神经病变等。也有学者提出尿毒症患者血中组胺、阿片样物质、糖基化终产物水平的升高,必需脂肪酸的缺乏以及透析过程均有可能导致尿毒症患者皮肤瘙痒的发生。     

Effects of phototherapy in neonates on circadian sleep-wake and saliva cortisol level rhythms

The influence of phototherapy treatment during the neonatal period on sleep-wake rhythm, and its long-term effects on biological rhythms, was evaluated in preterm and full-term infants. Forty-three infants treated with phototherapy during the neonatal period and 47 untreated infants were examined for entrainment of sleep-wake rhythms between 16 and 52 weeks and for sleep-wake and saliva cortisol rhythms at 2.5 years of age. The age of sleep-wake rhythm entrainment was not significantly different between the 2 groups. No correlations between duration of exposure to phototherapy and corrected age of entrainment of sleep-wake rhythm were observed. At follow-up, no significant differences in sleep-wake and saliva cortisol rhythms were observed between the 2 groups, indicating that circadian variations were similar to those in adults.