Sabzehei Mohammad Kazem, Waisi Shadi, Shokouhi Maryam, Tapak Leili
Pediatric Department, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Biostatistics, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Med J Islam Repub Iran. 2021 Dec 31;35:192. doi: 10.47176/mjiri.35.192. eCollection 2021.
Severe indirect hyperbilirubinemia causes neurotoxicity, leading to potential permanent injuries to the neonatal nervous system. The present study intended to compare the effectiveness and complications of Single-Surface Intensive Phototherapy (SSIP) and Double-Surface Intensive Phototherapy (DSIP) in treating non-hemolytic hyperbilirubinemia in the neonatal ward of the Besat Hospital, Hamadan, Iran. In this prospective randomized clinical trial, 150 healthy full-term neonates born between 37-42 weeks gestation with ages <14 days old and birth weights ≥2500 gr who were affected by non-hemolytic hyperbilirubinemia with total serum bilirubin of 15-20 mg/dL were randomly allocated to two groups. Each group (n=75) underwent either SSIP or DSIP. Demographics, bilirubin level alterations, weight, platelet count, number of defecation per day, and body temperature of the patients were monitored and recorded in a specific questionnaire. Data analysis was performed using SPSS version 26.0 software, with the Chi-square and independent t-test. The pre-intervention levels of indirect bilirubin were 17.07±1.46 mg/dL in the SSIP group and 17.10±1.54 mg/dL in the DSIP group (P-value = 0.853). After 24 and 48 hours of treatment, the mean indirect bilirubin level of the SSIP group reduced to 13.12±1.71 mg/dL and 9.69±1.68 mg/dL, respectively. In the DSIP group, the levels were 11.85±2.17 mg/dL and 8.43±1.56 mg/dL after 24 and 48 hours of treatment, respectively. The absolute reductions of indirect bilirubin were 7.76±3.28 mg/dL for the SSIP group and 8.96±4.49 mg/dL for the DSIP group (P-value = 0.458). Therefore, the indirect bilirubin levels were significantly different between the groups after 24 and 48 hours of treatment and at the time of discharge (P<0.05). There were no significant inter-group differences in weight, platelet count, and incidence of skin rash, while the number of defecation and body temperature were higher in the DSIP group (P <0.05). However, body temperature alterations had no clinical relevance. Compared to the SSIP, the DSIP showed faster effectiveness and led to a shorter hospital stay, while it did not entail higher levels of complications.
严重的间接胆红素血症会导致神经毒性，进而可能对新生儿神经系统造成永久性损伤。本研究旨在比较单面强化光疗（SSIP）和双面强化光疗（DSIP）在伊朗哈马丹贝萨特医院新生儿病房治疗非溶血性高胆红素血症的有效性和并发症。在这项前瞻性随机临床试验中，150名健康足月新生儿，孕周在37 - 42周之间，年龄小于14天，出生体重≥2500克，患有非溶血性高胆红素血症，总血清胆红素为15 - 20mg/dL，被随机分为两组。每组（n = 75）分别接受SSIP或DSIP治疗。通过特定问卷监测并记录患者的人口统计学数据、胆红素水平变化、体重、血小板计数、每日排便次数和体温。使用SPSS 26.0软件进行数据分析，采用卡方检验和独立样本t检验。干预前，SSIP组间接胆红素水平为17.07±1.46mg/dL，DSIP组为17.10±1.54mg/dL（P值 = 0.853）。治疗24小时和48小时后，SSIP组间接胆红素平均水平分别降至13.12±1.71mg/dL和9.69±1.68mg/dL。DSIP组治疗24小时和48小时后的水平分别为11.85±2.17mg/dL和8.43±1.56mg/dL。SSIP组间接胆红素的绝对降低值为7.76±3.28mg/dL，DSIP组为8.96±4.49mg/dL（P值 = 0.458）。因此，治疗24小时和48小时后以及出院时，两组间间接胆红素水平存在显著差异（P<0.05）。体重、血小板计数和皮疹发生率在组间无显著差异，而DSIP组的排便次数和体温较高（P <0.05）。然而，体温变化无临床意义。与SSIP相比，DSIP显示出更快的疗效，住院时间更短，且并发症水平并未更高。
