Takcı Sahin, Yiğit Sule, Bayram Gülperi, Korkmaz Ayşe, Yurdakök Murat
Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Turk J Pediatr. 2013 Jan-Feb;55(1):29-34.
In severe and rapidly increasing jaundice, the use of intensive phototherapy provides greater effectiveness and a faster decrement in bilirubin levels compared to conventional phototherapy. The aim of this study was to compare the effectiveness of two types of intensive phototherapy: intensive compact fluorescent tube (CFT) and intensive light-emitting diode (LED) phototherapy. Forty-three infants over 35 weeks of gestation with severe non-hemolytic hyperbilirubinemia were enrolled in the prospective study. All infants received multidirectional (circular-shaped) intensive phototherapy. Of these, 20 infants received CFT while 23 infants received LED phototherapy. Bilirubin levels and body temperatures were measured periodically, and the rates of bilirubin decrement were calculated. Mean serum bilirubin level of the 43 infants was 20.5±1.5 mg/dl at the beginning of the therapy and mean duration of phototherapy was 20.6±1.1 hours. The rate of mean bilirubin decline was 47.2% and the decrease was more prominent in the first four hours (0.84 ± 0.41 mg/dl/h). The rates of bilirubin decrement were comparable between the LED and CFT groups. Slightly elevated mean body temperature (37.1ºC) was determined in the CFT group (p<0.05). Intensive phototherapy units with both LED and CFT were effective, showing a decline of half the initial value of bilirubin during the study period in infants with non-hemolytic jaundice. This study shows that intensive phototherapy with either CFT or LED can provide rapid decrease in bilirubin levels in the first few hours. This rapid decline is important in cases that have high risk of bilirubin encephalopathy.
在严重且迅速加重的黄疸病例中，与传统光疗相比，强化光疗能更有效地降低胆红素水平，且降低速度更快。本研究旨在比较两种强化光疗的效果：强化紧凑型荧光灯管（CFT）光疗和强化发光二极管（LED）光疗。43例孕龄超过35周的重度非溶血性高胆红素血症婴儿被纳入这项前瞻性研究。所有婴儿均接受多方向（圆形）强化光疗。其中，20例婴儿接受CFT光疗，23例婴儿接受LED光疗。定期测量胆红素水平和体温，并计算胆红素下降率。治疗开始时，43例婴儿的平均血清胆红素水平为20.5±1.5mg/dl，平均光疗持续时间为20.6±1.1小时。平均胆红素下降率为47.2%，在前4小时下降更为显著（0.84±0.41mg/dl/h）。LED组和CFT组的胆红素下降率相当。CFT组的平均体温略有升高（37.1ºC）（p<0.05）。配备LED和CFT的强化光疗设备均有效，在研究期间，非溶血性黄疸婴儿的胆红素水平下降至初始值的一半。本研究表明，CFT或LED强化光疗均可在最初数小时内迅速降低胆红素水平。这种快速下降在有胆红素脑病高风险的病例中很重要。
