光纤光疗与传统光疗治疗足月新生儿高胆红素血症的疗效比较：一项随机对照试验。

Effectiveness of FIBEROPTIC phototherapy compared to conventional phototherapy in treating HYPERBILIRUBINEMIA amongst term neonates: a randomized controlled trial.

机构信息

Department of Paediatrics and Child Health, Kilimanjaro Christian Medical University College, P O Box 2240, Moshi, Tanzania.

Department of Paediatrics and Child Health, Kilimanjaro Christian Medical Centre, P O Box 3010, Moshi, Tanzania.

出版信息

BMC Pediatr. 2021 Jan 11;21(1):32. doi: 10.1186/s12887-020-02458-2.

DOI:10.1186/s12887-020-02458-2

PMID:33430819

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7798326/

Abstract

BACKGROUND

Neonatal jaundice is one of the most common problems in neonates. Effective treatment of jaundice requires therapeutic intervention with high quality phototherapy. Over recent years, several studies reported fiberoptic phototherapy to be less effective than conventional phototherapy in term neonates. Our study aimed to compare the effectiveness of fiberoptic phototherapy with a larger illuminated area and higher irradiance to conventional phototherapy methods.

METHODS

This was a randomized controlled trial conducted at the Kilimanjaro Christian Medical Centre (KCMC). A total of 41 term neonates, less than 7 days of age with unconjugated hyperbilirubinemia were randomized. Thirteen (13) neonates were allocated to receive fiberoptic phototherapy, 13 to blue light conventional phototherapy and 15 to white light conventional phototherapy. Effectiveness was assessed by comparing the duration of phototherapy, bilirubin reduction rate and side effects of treatment. The data was analyzed with the independent t-test.

RESULTS

The mean overall bilirubin reduction rate was comparable in the fiberoptic phototherapy group (0.74%/h) and the blue light conventional phototherapy group (0.84%/h), with no statistically significant difference (p-value 0.124). However, white light conventional phototherapy had a significantly lower mean overall bilirubin reduction rate (0.29%/h) as compared to fiberoptic phototherapy (p-value < 0.001). The mean treatment duration of phototherapy was 69 h, 68 h and 90 h in the fiberoptic, blue light conventional and white light conventional phototherapy groups respectively. Side effects such as loose stool and skin rash were noted in some participants who received conventional phototherapy. No side effects of treatment were noted in the fiberoptic phototherapy group.

CONCLUSION

The effectiveness of fiberoptic PT and blue light conventional PT were comparable in terms of bilirubin reduction rate and treatment duration, whereas fiberoptic phototherapy was more effective than white light conventional PT, with a significantly higher bilirubin reduction rate and shorter treatment duration. Fiberoptic phototherapy may mitigate side effects caused by conventional phototherapy.

TRIAL REGISTRATION

The Pan African Clinical Trial Registry, PACTR202004723570110 . Registered 22nd April 2020- Retrospectively registered.

摘要

背景

新生儿黄疸是新生儿最常见的问题之一。有效治疗黄疸需要高质量的光疗进行治疗干预。近年来，有几项研究报告称，光纤光疗在足月新生儿中的效果不如传统光疗。我们的研究旨在比较大面积光纤光疗和高辐照度与传统光疗方法的有效性。

方法

这是在乞力马扎罗基督教医学中心（KCMC）进行的一项随机对照试验。共有 41 名年龄小于 7 天的未结合高胆红素血症的足月新生儿参与随机分组。其中 13 名新生儿被分配接受光纤光疗，13 名接受蓝光传统光疗，15 名接受白光传统光疗。通过比较光疗持续时间、胆红素降低率和治疗副作用来评估疗效。使用独立 t 检验对数据进行分析。

结果

光纤光疗组（0.74%/h）和蓝光传统光疗组（0.84%/h）的总胆红素降低率平均值相当，无统计学差异（p 值 0.124）。然而，白光传统光疗的总胆红素降低率平均值明显较低（0.29%/h），与光纤光疗相比有显著差异（p 值<0.001）。光纤光疗、蓝光传统光疗和白光传统光疗组的光疗治疗时间平均值分别为 69 小时、68 小时和 90 小时。接受传统光疗的一些参与者出现了腹泻和皮疹等副作用。光纤光疗组未出现治疗相关副作用。