持续光疗与间歇光疗治疗新生儿高胆红素血症疗效及不良反应的Meta分析  

Comparison of efficacy and safety of intermittent versus continuous phototherapy in neonatal hyperbilirubinemia:a Meta-analysis

作　　者：何欢 段海梅 孙秋怡 何华云[1] HE Huan;DUAN Haimei;SUN Qiuyi;HE Huayun(Children′s Hospital of Chongqing Medical University,Chongqing 400014 China)

机构地区：[1]重庆医科大学附属儿童医院,重庆400014

出　　处：《循证护理》2023年第19期3436-3441,共6页Chinese Evidence-Based Nursing

摘　　要：目的:对持续光疗或间歇光疗治疗新生儿高胆红素血症的疗效及不良反应进行评价,为高胆红素血症患儿选择适宜的光疗方式提供证据。方法:计算机检索PubMed、Web of Science、EMbase、CINAHL、the Cochrane Library、中国知网(CNKI)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、万方数据库(WanFang Database)中关于新生儿持续光疗和间歇光疗效果的文献,检索时限为建库至2022年5月30日。由2名研究者独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.4软件进行Meta分析。结果:共纳入18篇文献,合计2 524例患儿。Meta分析结果显示,持续光疗与间歇光疗治疗前后胆红素变化量差异无统计学意义[SMD=0.06,95%CI(-0.06,0.19),P=0.32]。与持续光疗相比,间歇光疗不良反应发生率较低[OR=0.17,95%CI(0.14,0.22),P<0.000 01]。结论:现有证据表明,持续光疗与间歇光疗均能有效降低高胆红素血症患儿的血清胆红素浓度,其中间歇光疗比持续光疗能够更好地减少常见不良反应发生,但相关文献未开展光疗对患儿远期健康影响的研究,不同光疗治疗方式、时长界定不一致,尚需开展高质量、大样本、规范的随机对照试验来验证不同方式光疗效果,为临床选择适宜的光疗方式提供证据。Objective:To evaluate the efficacy and adverse reactions of continuous phototherapy and intermittent phototherapy in the treatment of neonatal hyperbilirubinemia,and provide a scientific basis for clinical treatment.Methods:The clinical randomized controlled studies and cohort studies of continuous phototherapy and intermittent phototherapy in the treatment of neonatal hyperbilirubinemia were retrieved from PubMed,Web of Science,EMbase,CINAHL,the Cochrane Library,CNKI,VIP,CBM,WanFang Database.The retrieval time was from the inception to May 30,2022.After independent literature screening,data extraction,and quality evaluation by two researchers,RevMan 5.4 software was used for Meta-analysis,and calculate the standardized mean difference(SMD)or odds ratio(OR)and 95%CI for each influencing factor.Results:A total of 18 articles with a total of 2524 neonates were included.Meta-analysis results showed that there was no significant difference in the change of bilirubin before and after continuous phototherapy and intermittent phototherapy(SMD=0.06,95%CI-0.06-0.19,P=0.32).Compared with continuous phototherapy,the incidence of adverse reactions of intermittent phototherapy was lower(OR=0.17,95%CI 0.14-0.22,P<0.00001).Conclusion:Current evidence shows that both continuous phototherapy and intermittent phototherapy can effectively reduce the serum bilirubin concentration in neonates with hyperbilirubinemia,and intermittent phototherapy can better reduce the occurrence of adverse reactions than continuous phototherapy.

关 键 词：间歇光疗 持续光疗 高胆红素血症 新生儿 META分析 循证护理 

分 类 号：R473.72[医药卫生—护理学]