Holtrop P C, Ruedisueli K, Maisels M J
Department of Pediatrics, William Beaumont Hospital, Royal Oak, MI 48073-6769.
Pediatrics. 1992 Nov;90(5):674-7.
Conventional phototherapy systems that simultaneously irradiate the front and the back of the baby lower the serum bilirubin level more rapidly than one-sided systems, but they are impractical. Fiberoptic phototherapy makes it easy to administer conventional phototherapy from above while the infant lies on a fiberoptic phototherapy blanket. Newborns with birth weights less than 2500 g were randomly assigned to receive either single (n = 37) or double (n = 33) phototherapy. The groups were similar in clinical and laboratory characteristics. After 18 hours of therapy the serum bilirubin concentration declined by 31 +/- 11% in the double and 16 +/- 15% in the single phototherapy group (2.9 +/- 1.1 vs 1.6 +/- 1.4 mg/dL), and the difference in the total serum bilirubin levels after 18 hours of therapy was significant (double phototherapy group 7.1 +/- 2.7 mg/dL vs single phototherapy group 8.2 +/- 2.6 mg/dL). After 18 hours of treatment the serum bilirubin level was less than the phototherapy threshold level in 26 of 37 single phototherapy patients vs 32 of 33 double phototherapy patients. Double phototherapy was well tolerated. It is concluded that this type of double phototherapy is more effective than single phototherapy in low birth weight newborns. Double phototherapy may be useful when it is necessary to reduce an elevated serum bilirubin level as rapidly as possible or when the bilirubin level is rising with single phototherapy.
同时照射婴儿前后部的传统光疗系统比单侧系统能更快速地降低血清胆红素水平，但它们不实用。光纤光疗使得在婴儿躺在光纤光疗毯上时从上方进行传统光疗变得容易。出生体重小于2500克的新生儿被随机分配接受单次（n = 37）或双次（n = 33）光疗。两组在临床和实验室特征方面相似。治疗18小时后，双次光疗组血清胆红素浓度下降了31±11%，单次光疗组下降了16±15%（2.9±1.1对1.6±1.4毫克/分升），治疗18小时后总血清胆红素水平的差异具有显著性（双次光疗组7.1±2.7毫克/分升对单次光疗组8.2±2.6毫克/分升）。治疗18小时后，37名单次光疗患者中有26名血清胆红素水平低于光疗阈值水平，而33名双次光疗患者中有32名。双次光疗耐受性良好。得出的结论是，这种双次光疗在低出生体重新生儿中比单次光疗更有效。当需要尽快降低升高的血清胆红素水平或单次光疗时胆红素水平上升时，双次光疗可能会有用。
