The Correlation Between Patent Ductus Arteriosus And Accumulated Time Of Early Phototherapy In Premature Infants And The Intervention

Objective:To investigate the correlation between patent ductus arteriosus and the early accumulated phototherapy time in premature infants,and whether chest shielding during phototherapy can be used as a protective measure to reduce the incidence of patent ductus arteriosus in premature infants..Methods:In this study,premature infants hospitalized in the neonatal department of Fujian Provincial Maternity and Children's Hospital from May 1,2018-August 31,2018 were randomly divided into two groups according to the inclusion and exclusion criteria.Among them,the experimental group received chest shielding phototherapy within 72 hours after birth and the control group received no chest occlusion phototherapy.Blood samples of the radial artery were collected on admission and 72 hours after birth to measure the plasma prostaglandin E2 level by Elisa,and echocardiography was performed 72 hours after birth to determine the PDA status,and relevant clinical characteristics were recorded.Results: A total of 112 premature infants with gestational age < 34 weeks were included in this study.The incidence of PDA was 15/54 in the experimental group and 19/58 in the control group.This study suggested that the occurrence of PDA was positively correlated with the accumulated phototherapy time within 72 hours after birth(OR value =1.704,P value < 0.05),but not significantly correlated with the occlusion of chest phototherapy(OR=0.918,P value > 0.05).The occurrence of PDA was negatively correlated with the degree of PGE2 reduction on the first to the third day after birth(?=-0.314,P<0.05).The accumulated phototherapy time within 72 hours after birth was not significantly correlated with the degree of PGE2 reduction(Z value =-1.806 in the test group,P value was > 0.05;Z value =-0.857 in the control group,P value > 0.05),and there was no significant correlation between PGE2 level and chest shielidng phototherapy(Z value =3.111,P value > 0.05).There were no significant differences between the two groups in the incidence of apnea,pulmonary hemorrhage,intraventricular hemorrhage,necrotizing enterocolitis,bronchopulmonary dysplasia,duration of oxygen therapy,length of stay,and hospitalization cost.Conclusion:The randomised controlled trial of chest shielding phototherapy on premature infants showed that the accumulated phototherapy time within 72 hours after birth was an independent risk factor for PDA,and the occlusion phototherapy had no significant protective effect on PDA and no significant improvement on the prognosis of the infants.The higher the degree of blood PGE2 decreased from the first day to the third day after birth,the lower the incidence of PDA was.The accumulated phototherapy time within 72 hours after birth did not affect the blood PGE2 level,while chest shielding phototherapy did not affect blood PGE2 level.