Clinical effect of intermittent blue light phototherapy combined with intravenous infusion of albumin on neonatal pathological jaundice

Abstract

Objective To investigate the clinical efficacy and safety of different blue light phototherapy methods combined with intravenous albumin infusion in the treatment of neonatal pathological jaundice. Methods From February 2015 to October 2017, 82 cases of neonatal pathological jaundice admitted to Dongying District People′s Hospital in Dongying City were selected into this study. They were randomly divided into experimental group (n=41, received intermittent blue light irradiation+ intravenous albumin infusion) and control group (n=41, received continuous blue light irradiation+ intravenous albumin infusion). Independent-samples t test was used to statistically compare the neonatal weight, gestational age, and serum total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), hypersensitive C-reactive protein (HS-CRP), total bile acid (TBA), free fatty acid (FFA), alkaline phosphatase (AKP) and γ-glutamyltranspeptidase (γ-GT) levels between two groups. Chi-square test was used to statistically analyze the gender composition ratio, total effective rate and incidence of adverse reactions between two groups. The procedure followed in this study conforms to the ethical standards formulated by the Medical Ethics Committee of People′s Hospital of Dongying District, Dongying City, and has been approved by the Committee (Approval No. 20150103). All subjects have signed informed consent forms for clinical research. Results ① There were no significant differences in the aspects of gender composition ratio, body weight and gestational age between two groups (P>0.05). ② The levels of serum TBIL, DBIL and IBIL in experimental group were (153.9±9.6) μmol/L, (8.2±2.4) μmol/L and (139.6±8.9)μmol/L, respectively on the 7th day after treatment, which were significantly lower than (208.2±11.2)μmol/L, (20.9±2.8)μmol/L and (191.3±8.1)μmol/L before the treatment. The differences between two groups were statistically significant (t=23.549, 23.055, 27.429; P 0.05). ③ The levels of HS-CRP, TBA, FFA, AKP and γ-GT on the 7th day after treatment in experimental group were(1.3±0.3)mg/L, (12.3±3.4)μmol/L, (2 493.0±199.7)μmol/L, (126.2±10.2)μmol/L, (60.5±10.3)μmol/L, respectively, which were significantly lower than that (3.4±0.4)mg/L(32.6±5.9)μmol/L, (4 049.8±132.8)μmol/L, (238.7±11.4)μmol/L, (151.7±11.3)μmol/L before the treatment. And the differences were statistically significant (t=26.091, 19.138, 41.560, 47.061, 38.174, P 0.05). ④ The total effective rate of experimental group was 95.1%(39/41), which was higher than 92.7%(38/41) of control group. But there was no significant difference between two groups (χ2=0.210, P=0.644). ⑤ The incidence of adverse reactions, such as diarrhea, dehydration, body temperature rise, milk volume decrease, crying and dysphoria in experimental group were lower than those in control group, and all the differences between two groups were statistically significant (χ2=4.491, 6.252, 5.623, 7.291, 5.143; P=0.032, 0.013, 0.024, 0.012, 0.022). Conclusions Intermittent blue light phototherapy combined with intravenous albumin infusion has a better effect on neonatal pathological jaundice, and can significantly reduce the incidence of adverse reactions in children. Key words: Jaundice, neonatal; Phototherapy; Serum; Bilirubin; C-reactive protein; Infant, newborn