ICU, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Acta Paediatr. 2012 May;101(5):458-65. doi: 10.1111/j.1651-2227.2011.02561.x. Epub 2012 Jan 9.
Various light-emitting diode (LED) phototherapy devices have been trialled on the assumption of a more effective spectral distribution of the light emitted. We reviewed the current literature to determine whether LED is more effective than other types of phototherapy. Eligible studies were randomized controlled trials of LED versus other phototherapies. Studies were found to be of medium quality based on a components approach. Data were statistically aggregated within a very homogeneous population (term or late preterm neonates). Results appeared robust at sensitivity analysis. Five hundred and eleven neonates were included in the meta-analysis. LED and other phototherapy devices appeared to be equally effective in reducing total serum bilirubin (TSB) in term or late preterm neonates. The pooled mean TSB rate of decrease was 3.269 μmol/L/h (0.191 mg/dL/h) and 3.074 μmol/L/h (0.18 mg/dL/h) in the LED and conventional arms, respectively [average difference in TSB rate of decrease = 0.194 μmol/L/h (0.011 mg/dL/h) in favour of LED phototherapy; p = 0.378].
No significant difference in TSB rate of decrease was detected between LED and other types of phototherapy. Further randomized controlled trials are needed to ascertain whether LED phototherapy may be more effective when increasing the spectral power, or in certain selected subpopulations.
假设发光二极管(LED)发出的光具有更有效的光谱分布,各种 LED 光疗设备已进行了试验。我们回顾了当前的文献,以确定 LED 是否比其他类型的光疗更有效。
合格的研究为 LED 与其他光疗的随机对照试验。基于组件方法,研究被评为中等质量。数据在非常同质的人群(足月或晚期早产儿)内进行了统计学汇总。在敏感性分析中,结果似乎是稳健的。共有 511 名新生儿纳入荟萃分析。
在足月或晚期早产儿中,LED 和其他光疗设备似乎在降低总血清胆红素(TSB)方面同样有效。LED 和常规组的平均 TSB 下降率分别为 3.269 μmol/L/h(0.191 mg/dL/h)和 3.074 μmol/L/h(0.18 mg/dL/h)[TSB 下降率的平均差异= 0.194 μmol/L/h(0.011 mg/dL/h)有利于 LED 光疗;p=0.378]。
未检测到 LED 和其他类型的光疗之间 TSB 下降率的显著差异。需要进一步的随机对照试验来确定在增加光谱功率或在某些选定的亚组中,LED 光疗是否更有效。