Factors That Influence The Efficacy Of Phototherapy In Full-term Neonatal Jaundice And Management Of Failure Of Phototherapy

Objective The subjects of this study are analyzing the factors that may influence the efficacy of phototherapy and study the incidence of "failure of phototherapy" in full-term newborns in Nanning and the correlative factors to it. Method The subjects were 299 full-term infants who admitted between January 2004 and December 2004. The total bilirubin levels reached the criteria for "these jaundice should be treated"in 160 of them. The management of neonatal jaundice was based on the National Intervention Recommendation in Neonatal Jaundice in 2001. 76 cases were chosen into our study to analyze the efficacy of phototherapy. They were divided into "failure of phototherapy" group and "non-failure of phototherapy" group. According to the National Intervention Recommendation in Neonatal Jaundice in 2001, the serum bilirubin rises 8.6μmol(/L.h)[0.5mg(/dl.h)] after receiving 4 to 6 hours of phototherapy is defined as "failure of phototherapy". Result (1) In 76 cases, the efficacy of phototheray of 10 cases belonged to "failure of phototherapy", 66 cases belonged to " non-failure of phototherapy". The incidence of failure of phototherapy was 13.2%; (2) There were significant differences in parity, hematocrit count and the rate of exchange transfusion before phototherapy ( P Value was <0.01,<0.05,005, respectively); (3) There was correlation between hemoglobin concentration, hematocrit count , exchange transfusion before phototherapy and failure of phototherapy in statistics ( P Value was <0.05,<0.05,<001,respectively). Conclusion The incidence of"failure of phototherapy"in Nanning was 13.2% in full-term newborns in Nanning. Hemoglobin concentration of low level, low reticulocyte counts and exchange transfusion before phototherapy may correlate to failure of phototherapy.