Romagnoli Costantino, Zecca Enrico, Papacci Patrizia, Vento Giovanni, Girlando Pietro, Latella Caterina
Division of Neonatology, Catholic University of Rome, Rome, Italy.
Fetal Diagn Ther. 2006;21(2):204-9. doi: 10.1159/000089304.
To compare the effectiveness of various phototherapy systems in lowering serum bilirubin levels in preterm infants.
This randomized clinical trial enrolled 140 preterm infants with gestational age < or =30 weeks and presenting nonhemolytic hyperbilirubinemia. When total serum bilirubin level reached 6.0 mg/dl (102.6 micromol/l), eligible infants were randomly assigned to four study groups: conventional, fiberoptic Wallaby, fiberoptic Biliblanket, and combined phototherapy. Efficacy was assessed by comparing highest serum bilirubin levels, duration of treatment, and number of infants requiring exchange transfusion.
Our results confirm that fiberoptic phototherapy, both Wallaby and Biliblanket, had the same effectiveness of conventional phototherapy. The best results have been obtained using combined phototherapy, which allowed to reach lower serum bilirubin levels, a shorter duration of treatment and a significant reduction of exchange transfusions.
Our data suggest that combined phototherapy should be the method of choice in treating hyperbilirubinemia in very preterm infants.
比较不同光疗系统降低早产儿血清胆红素水平的效果。
这项随机临床试验纳入了140例胎龄小于或等于30周且患有非溶血性高胆红素血症的早产儿。当血清总胆红素水平达到6.0mg/dl（102.6微摩尔/升）时，符合条件的婴儿被随机分配到四个研究组：传统光疗组、光纤沃拉比光疗组、光纤蓝光毯光疗组和联合光疗组。通过比较最高血清胆红素水平、治疗持续时间以及需要换血治疗的婴儿数量来评估疗效。
我们的结果证实，光纤光疗（沃拉比光疗和蓝光毯光疗）与传统光疗效果相同。联合光疗取得了最佳效果，能够使血清胆红素水平更低、治疗持续时间更短且换血治疗显著减少。
我们的数据表明，联合光疗应成为治疗极早产儿高胆红素血症的首选方法。
