Shoris Irit, Gover Ayala, Toropine Arina, Iofe Adir, Zoabi-Safadi Rasha, Tsuprun Svetlana, Riskin Arieh
Department of Neonatology, Bnai Zion Medical Center, 47 Golomb Street, P.O. Box 4940, Haifa 31048, Israel.
Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, P.O. Box 9697, Haifa 32000, Israel.
Children (Basel). 2023 Oct 17;10(10):1699. doi: 10.3390/children10101699.
Neonatal hyperbilirubinemia is an extremely common metabolic complication of the neonatal period which may be associated with bilirubin encephalopathy and even death. Adverse neurological consequences are preventable if a timely diagnosis and treatment are provided. Phototherapy is usually the preferred option to decrease hyperbilirubinemia. Although considered to be safe, evidence in recent years has shown that this treatment may not be free of side effects and short- and long-term unfavorable outcomes. These are usually mild or rare, but should be decreased or avoided if possible. Many useful complementary measures and treatments have been described that could shorten the duration of exposure to phototherapy. However, there is no current unequivocal recommendation to use any of the methods presented in this review. Our review aims to depict the wide range of possible complementary treatments to phototherapy, and to provide the scientific and clinical evidence available regarding their usefulness. It is essential that, while utilizing the full potential of phototherapy to treat hyperbilirubinemia, caregivers are aware of its side effects and possible inherent dangers, and seek ways to minimize the exposure to phototherapy to what is really needed for the newborn. Further studies are needed to clarify the preferred complementary treatments that could reduce the duration of exposure to phototherapy without impairing its effectiveness.
新生儿高胆红素血症是新生儿期极为常见的代谢并发症,可能与胆红素脑病甚至死亡相关。如果能及时诊断和治疗,不良神经后果是可预防的。光疗通常是降低高胆红素血症的首选方法。尽管光疗被认为是安全的,但近年来的证据表明,这种治疗可能并非没有副作用以及短期和长期的不良后果。这些副作用通常较轻或较为罕见,但如果可能应减少或避免。已经描述了许多有用的辅助措施和治疗方法,它们可以缩短光疗的照射时间。然而,目前对于使用本综述中提及的任何方法并没有明确的推荐。我们的综述旨在描述光疗可能的广泛辅助治疗方法,并提供有关其有效性的科学和临床证据。至关重要的是,在充分发挥光疗治疗高胆红素血症潜力的同时,护理人员要意识到其副作用和潜在风险,并寻求方法将新生儿接受光疗的时间降至真正所需的最低限度。需要进一步研究以明确能在不损害光疗效果的情况下减少光疗照射时间的首选辅助治疗方法。