苯巴比妥钠联合蓝光照射治疗难治性或迁延性新生儿黄疸的研究

目的 观察苯巴比妥联合蓝光照射治疗难治性或迁延性新生儿黄疸的临床有效性.方法 2011年12月至2014年6月诊断为难治性或迁延性新生儿黄疸患儿,采用数字表法随机分为2组（各60例）,2组患儿性别、胎龄、出生体质量、日龄,民族等进行比较差异有统计学意义（P＜0.05）,对照组60例采用蓝光照射,观察组60例采用蓝光照射联合苯巴比妥治疗;比较2组患儿皮肤及巩膜黄染改变情况、住院时间、血清总胆红素值.结果 观察组患儿住院时间（10.62±2.51）d,对照组为（15.10±2.16）d,运用两独立样本t检验对住院时间进行比较,差异有统计学意义（t=-7.538,P=0.001）;观察组患儿治疗前血清总胆红素值为（315.9±62.3）μmol/L、治疗后为（107.3±12.2）μmol/L,对照组患儿治疗前血清总胆红素值为（313.8±60.4） μmol/L、治疗后为（138.5±16.4）μmol/L,对治疗前观察组和对照组进行完全随机设计两样本均数比较的检验,差异无统计学意义（t=0.163,P=0.872）,对治疗后观察组和对照组进行完全随机设计两样本均数比较的舱验,差异有统计学意义（t=-8.759,P=0.001）.2组患儿治疗疗效运用秩和检验比较,差异有统计学意义（z=-4.845,P=0.001）.结论 蓝光照射联合应用苯巴妥钠口服可作为难治性或迁延性新生儿黄疸的有效治疗手段,具有临床可行性。

Clinical Efficacy of Phenobarbital Combined with Blue Light Treatment on Refractory or Protracted Neonatal Jaundice

Objective The aim of this study was to observe the clinical efficacy of phenobarbital combined with blue light treatment on refractory or protracted neonatal jaundice. Methods The patients with refractory or protracted neonatal jaundice in Kunming Children＇s Hospital from December 2011 to June 2014 were randomly divided into two groups by numeration table method. The control group（60 cases） was treated with blue light treatment,and the observation group（60 cases） was given blue light and phenobarbital therapy. The changes of skin and icteric sclera, length of stay,and serum total bilirubin of two groups were compared. Results The hospital stays of the observation group and control group were 10.62 ± 2.51 and 15.10 ± 2.16 days, respectively.There was a statistical significant difference in the hospital stays between the two groups by the independent sample t-test（t =-7.538,P = 0.001）. The serum total bilirubin of the observation group was 315.9±62.3 and 107.3±12.2 mol/L before and after treatment,respectively,while that of the control group was 313.8±60.4 and 138.5±16.4 mol/L, respectively. The difference in the serum total bilirubin between observation and control groups was no statistical significant before treatment by the two sample mean completely random designed t-test（t = 0.163,P =0.872）, while there was a statistical significant difference after treatment（t =-8.759,P = 0.001）. The curative effects of two groups were compared by the rank sum test, and the difference was statistically significant.（z =-4.845,P = 0.001）. Conclusion Phenobarbital combined with blue light therapy has the clinical feasibility,may be used as an effective treatment for refractory or protracted neonatal jaundice.