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目的 探讨黄疸新生儿光疗时白蛋白的应用价值。方法 对 60例入选黄疸新生儿进行前瞻性双盲研究 ,随机分为 2组 :即光疗加白蛋白输注组 (PA组 ,白蛋白 1.5g/kg)和单纯光疗组 (PO组 ) ,各 3 0例 ;光疗前两组基本条件相似。根据总胆红素水平PA组和PO组进一步细分为轻度黄疸组、中度黄疸组和重度黄疸组 3组。所有入选新生儿均持续光疗 48h ,并分别于光疗前和光疗 6,12 ,2 4,48及 72h后抽血检查。结果 ①在PA组 ,光疗前及光疗 6,12 ,2 4,48及 72h后 ,其血清总胆红素分别为 (2 5 1± 3 7) ,(2 3 1± 3 7) ,(2 0 4± 2 7) ,(171± 41) ,(13 0± 5 3 )和 (13 6± 40 ) μmol/L,而在PO组则分别为 (2 43± 2 9) ,(2 3 1± 2 9) ,(2 0 7± 3 3 ) ,(166± 3 6) ,(12 3± 3 6)与 (13 4± 42 ) μmol/L,两组各时段总胆红素水平极为相近 (P >0 .0 5 ) ;②光疗 12h后总胆红素水平开始明显下降 ,PA组和PO组的下降速度和下降类型完全一样 ;③轻度黄疸组光疗 12h后总胆红素水平接近 171μmol/L,2 4h后 171μmol/L 以下 ;而中度黄疸组光疗 2 4h后才接近 171μmol/L,48h后 171μmol/L以下。结论 白蛋白输注对黄疸新生儿的光疗效果无明显作用 ;建议对轻度黄疸的新生儿光疗 12h ,中度黄疸者 2 4h ,重度黄疸者应适当延长光疗
Objective To investigate the clinical value of albumin in neonatal jaundice during phototherapy. Methods Sixty cases of neonatal jaundice were prospectively and double-blindly randomized into two groups: light therapy plus albumin infusion group (PA group, albumin 1.5g / kg) and simple phototherapy group (PO group) 30 cases; the basic conditions before the two groups were similar. According to total bilirubin levels, PA and PO groups were further subdivided into mild jaundice group, moderate jaundice group and severe jaundice group. All selected newborns continued phototherapy 48h, and were in the phototherapy before and after phototherapy 6,12,2,48 and 72h after blood tests. Results ① The levels of total bilirubin in the PA group, before phototherapy and at 6, 12, 2, 44, and 72 hours after phototherapy were (2131 ± 37), (2131 ± 37, 0 4 ± 2 7, 171 ± 41, 13 0 ± 5 3 and 13 6 ± 40 μmol / L, respectively, while in PO group it was (2 43 ± 2 9), (2 3 1 The levels of total bilirubin in the two groups were similar to those in the two groups (P <0.01) (P> 0.05) .②The level of total bilirubin began to decrease significantly after 12 hours of phototherapy, the rate of descent in PA group and PO group was exactly the same as that of descending type. ③The levels of total bilirubin in mild jaundice group after 12 hours phototherapy 171μmol / L for 24 hours and 171μmol / L for 24 hours. However, moderate jaundice was only 171μmol / L after 24 hours and 171μmol / L for 48 hours. Conclusions Albumin infusion has no significant effect on the phototherapy effect of neonatal jaundice. It is suggested that neonates with mild jaundice should be treated with phototherapy for 12 hours, moderate jaundice for 24 hours and severe jaundice for phototherapy