换血疗法联合口服布拉氏酵母菌散治疗新生儿重症黄疸疗效的研究  

Study on efficacy of exchange transfusion therapy combined with oral administration of Saccharomyces boulardii Sachets in treatment of severe neonatal hyperbilirubinemia

作　　者：杨培源 时俊萍 王富明 徐倩倩 唐军 Yang Peiyuan;Shi Junping;Wang Fuming;Xu Qianqian;Tang Jun(Pediatrics Department,Kaifeng Children's Hospital,Kaifeng,Henan 475000,China)

机构地区：[1]开封市儿童医院儿科,河南开封475000

出　　处：《齐齐哈尔医学院学报》2024年第24期2345-2348,共4页Journal of Qiqihar Medical University

基　　金：开封市科技发展计划项目(2107011)。

摘　　要：目的探讨换血疗法联合口服布拉氏酵母菌散对重症黄疸新生儿的临床疗效及安全性。方法选择2021年1月—2024年4月本院新生儿重症监护室(NICU)收治的实施换血退黄治疗的重症黄疸新生儿作为研究对象,共82例患儿。按随机数表法分为对照组和治疗组两组,每组各41例。对照组给予蓝光照射及换血疗法退黄治疗等基础治疗,治疗组给予蓝光照射及换血疗法退黄治疗并口服布拉氏酵母菌散的综合治疗;两组患儿初次换血后进行评估,必要时再次换血;记录患儿换血原因及一般资料,患儿换血前及换血后检测肝功了解血清总胆红素及直接胆红素水平等结果,记录患儿住院天数、治疗过程中出现的与换血相关的不良事件。结果共入组82例新生儿重症黄疸病例,因为有4例新生儿进行再次换血,实际完成86例次换血退黄治疗;治疗组41例新生儿(其中1例进行第2次换血),对照组41例新生儿(其中3例进行第2次换血);82例患儿中25例(30.4%)是ABO溶血病(其中1例进行第2次换血),6例(7.3%)是Rh溶血病(其中2例进行第2次换血),4例(4.9%)是败血症,2例(2.5%)是胆红素脑病,1例(1.2%)是颅内出血,44例(53.7%)是其他原因引起的重症高胆红素血症(其中1例进行第2次换血)。治疗组患儿在换血治疗前血清总胆红素检测值为(408.7±98.7)μmol/L,血清直接胆红素检测值为(23.2±8.7)μmol/L,换血治疗后的血清TSB为(403.9±125.9)μmol/L,血清DB为(25.0±16.8)μmol/L。治疗组患儿与对照组患儿在血清总胆红素、直接胆红素方面比较,差异无统计学意义(P>0.05)。换血治疗后,治疗组患儿的血清总胆红素检测值为(194.8±61.2)μmol/L,血清直接胆红素检测值为(18.5±5.3)μmol/L,对照组换血治疗后的血清TSB为(258.3±76.1)μmol/L,血清DB为(30.2±27.2)μmol/L。治疗组患儿的血清总胆红素检测值及直接胆红素检测值均低于对照组,差异有统计学意义(P<0.05)。治疗后患�Objective To study the efficacy and safety of exchange transfusion therapy combined with oral administration of Saccharomyces boulardii sachets in treating neonates with severe hyperbilirubinemia.Methods All children admitted to the hospital from January 2021 to April 2024 with severe jaundice were selected,and those undergoing exchange blood therapy for severe hyperbilirubinemia in the NICU were chosen as study subjects.Among the 82 children who met the criteria for exchange transfusion therapy,they were randomly assigned to a control group and a treatment group using the random number table method,with 41 cases in each group.The control group received basic treatments such as blue phototherapy and exchange blood treatment.The treatment group received blue phototherapy,exchange blood treatment,and oral administration of Saccharomyces boulardii sachets.Both groups were evaluated after the initial blood exchange,and a second blood exchange was performed if necessary.The reasons for the blood exchange and general information were documented,and both serum total bilirubin and direct bilirubin levels were assessed before and after the treatment.Additionally,the length of hospital stay and adverse events,such as complications and procedures related to the exchange blood during treatment,were recorded.Results A total of 82 neonates with severe jaundice were enrolled in the study,and since 4 neonates underwent a second exchange transfusion,a total of 86 exchange transfusions were actually completed.There were 41 neonates in the treatment group(including 1 who underwent a second exchange transfusion)and 41 neonates in the control group(including 3 who underwent a second exchange transfusion).Among the 82 cases,25(30.4%)had ABO hemolytic disease(with 1 undergoing a second exchange transfusion),6(7.3%)had Rh hemolytic disease(with 2 undergoing a second exchange transfusion),4(4.9%)had sepsis,2(2.5%)had bilirubin encephalopathy,1(1.2%)had intracranial hemorrhage,and 44(53.7%)had severe hyperbilirubinemia due to other causes

关 键 词：新生儿 重症高胆红素血症 换血疗法 布拉氏酵母菌散 

分 类 号：R722.17[医药卫生—儿科]