早產(chǎn)兒黃疸早期干預(yù)的臨床觀察

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1、·336·中國(guó)新生兒科雜志2008年第23卷第6期·論著·早產(chǎn)兒黃疸早期干預(yù)的臨床觀察劉穎樸梅花【摘要】目的探討早期干預(yù)早產(chǎn)兒黃疸的療效和對(duì)腸外營(yíng)養(yǎng)及體質(zhì)量增長(zhǎng)的影響。方法174例早產(chǎn)兒，出生體質(zhì)量1500～2000g者(A組)87例，出生體質(zhì)量<1500g者(B組)87例，分別按常規(guī)干預(yù)和早期干預(yù)分組。常規(guī)組血清總膽紅素(TSB)達(dá)干預(yù)推薦方案的標(biāo)準(zhǔn)時(shí)光療，早期組于出現(xiàn)黃疸，但TSB未達(dá)干預(yù)標(biāo)準(zhǔn)即光療。結(jié)果A、B組的早期組膽紅素峰值(PSB)均低于常規(guī)組[A組：(209．48-1-38．99)txmol／L和(266．59±37．11)I,Lmol／L

2、，B組：(180．23±31．63)m0l／，L和(243．68±37．45)~moL／L，P均<0．05]；早期組與常規(guī)組相比黃疸消退日齡早[A組：(14．5±4．4)d和(18．0±3．8)d，B組：(10．8±3．0)d和(18．84-5．5)d，P均<0．05l，脂肪乳起始日齡早[A組：(5．8±2．7)d和(8．1±3．7)d，P>0．05；B組：(3．8±1．8)d和(9．2±4．4)d，P<0．05]，恢復(fù)出生體質(zhì)量日齡早[A組：(13．14-6．0)d和(14．4±4．0)d，P>0．05；B組：(9．3±4．8)d和(15．4±5．6)

3、d，P<0．05]。結(jié)論早期干預(yù)可以使早產(chǎn)兒尤其是極低出生體重兒PSB降低，黃疸持續(xù)時(shí)間縮短，利于早期添加脂肪乳和早產(chǎn)兒體質(zhì)量增長(zhǎng)。【關(guān)鍵詞】黃疽；干預(yù)性研究；臨床方案EfectsofearlytreatmentonjaundiceinprematureinfantsLIUYing，PIAOMei-hua．PekingUniversityThirdHospital，Beijing100083，ChinaCorrespondingauthor：PIAOMei—hua，Email：pmh1990@sina．com【Abstract】objectiveToin

4、vestigatetheclinicaleffectsofearlyphototherapyofjaundiceinprematureinfantsanditsinfluenceonparenteralnutritionandweightgain．Methods87prematureinfantswithbirth—weightbetween1500—2000g(groupA)and87prematureinfantswithbirth—weightlessthan1500g(groupB)wereenrolledintothestudy．Ineachg

5、roup，subjectsweredividedintotwosubgroups，i．e．conventionaltreatmentgroup，withthetreatmentconductedaccordingtotherecommendedguidelinesoftreatmentforneonataljaundicewhichwasconstitutedin2000；andtheearlytreatmentgroup，withtreatmentearlierthantheaboverecommendedguidelines．Comparisonsw

6、eremadebetweensubgroupsinAandBgroups．SPSS11．0softwarewasusedforstatisticalanalysisofdata．ResultsPeakserumbilirubin(PSB)levelinearlytreatmentgroupwassignificantlyhigherthanthatinconventionaltreatmentgroupbothingroupAandB[(209．48±38．99)m0l／，Land(266．59±37．11)mol／／LingroupA，P<0．05；(

7、180．234-31．64)mol／／Lvs(243．68±37．45)~moVLingroupB，P<0．05]．Thetimeofjaundicedisappearinginearlytreatmentgroupwassignificantlyearlierthanthatinconventionaltreatmentgroup，bothingroupAandB[(14．5±4．4)days(18．0±3．8)daysingroupA，P<0．05；(10．8±3．0)daysvs(18．8±5．5)daysingroupB，P<0．05]．Mean

8、while，theearlytreatmentgroupcommencedint