To Analyse The Risk Facters And The Dose-Effect Of Double-Surface Phototherapy For Neonatal Hyperbilirubinemia

Objective To review and analyse the clinical risk factors and the dose-effect of blue-light double-surface continuous phototherapy for moderate and severe neonatal hyperbilirubinemia.Methods Retrospective analysis on data collected from August,2009 to September,2010 was performed.The records of 114 were suffering from neonatal hyperbilirubinemia in the department of neonatal in The First Affiliated Hospital of Guangxi Medical University.Each case meets the recommendation for intervention in our country.114 cases were divided into 3 groups according to the venous total serum bilirubin(TSB) levels.To observe the rate of reduction of serum bilirubin during the first 4 hours and the last hours in 24 hours after initiation of phototherapy by using the capillary TSB. The recorded data were concluded risk of facters,gestational age,the age in beginning of PT,erythrocyte,hemoglobin,albumin and so on. All of which were analyzed by the statistic software SPSS 13.0.Results (1) G6PD deficiency and prenatal factors are the major risk of factors.The beginning time of PT in the multi-factors group is earlier than the simple-facter one (z=-2.180,p<0.05),and is higher in the TSB levels(t=-2.011,p<0.05).(2)Before phototherapy,there are no obvious differences between the value of capillary and venous TSB levels(p>0.05).(3)In each group,a significant decrease of TSB level can be seen in the first 24 hours(p<0.05),and the most significant decline occurred in the first 4 hours(p<0.05). (4)The age in beginning of PT,lbumin,B/A are related to the difference of TSB levels.Conclusion (1) G6PD deficiency and perinatal factors are the major risk of factors in moderate and severe neonatal hyperbilirubinemia..(2) We can explore that the rate of decline in TSB in the first 4 hours is faster than the rest 20 hours in blue-light double-surface continuous phototherapy. To the moderate TSB level,phototherapy may be discontinued up to 24 hours later. (3) It is necessary to monitor albumin,B/A for neonatal hyperbilirubinemia.