茵栀黄联合双歧杆菌治疗新生儿黄疸的临床价值研究(1)
【摘要】 目的：分析茵栀黄、双歧杆菌联合治疗新生儿黄疸的临床应用价值。方法：选取2017年5月-2018年9月笔者所在医院接收的黄疸新生儿126例，将其随机分为对照组60例和治疗组66例。对照组患儿给予茵栀黄治疗，治疗组患儿给予茵栀黄联合双歧杆菌进行治疗。比较两组治疗效果。结果：治疗组治疗总有效率高于对照组，差异有统计学意义(P<0.05)。治疗后治疗组患儿72 h TCB下降值、日均TCB下降值均明显高于对照组，差异有统计学意义(P<0.05)。治疗组黄疸消退时间短于对照组，复发率低于对照组，差异均有统计学意义(P<0.05)。两组新生儿均未有不良反应发生。结论：临床上采用双歧杆菌、茵栀黄联合方式治疗新生儿黄疸，可有效缩短黄疸症状消退时间、改善TCB水平，治疗后复发率较低，且不会增加副作用，治疗效果良好，值得推广。
【关键词】 黄疸 新生儿 双歧杆菌 茵栀黄 治疗效果
[Abstract] Objective： To analyze the clinical value of Yinzhihuang combined with Bifidobacterium in the treatment of neonatal jaundice. Method： From May 2017 to September 2018， 126 neonates with jaundice received in the pediatrics department of our hospital were selected and randomly divided into the control group (60 cases) and the treatment group (60 cases). Children in the control group were treated with Yinzhihuang， while children in the treatment group were treated with Yinzhihuang combined with Bifidobacterium. The therapeutic effect of the two groups was compared. Result： The total effective rate of the treatment group was significantly higher than that of the control group， and the difference was statistically significant (P<0.05). After treatment， the decrease value of TCB in the treatment group at 72 h and the average daily value of TCB in the control group were significantly higher than those in the control group， the differences were statistically significant (P<0.05). The regression time of jaundice in the treatment group was shorter than that in the control group， and the recurrence rate was lower than that in the control group， the differences were statistically significant (P<0.05). Conclusion： The clinical treatment of neonatal jaundice with Bifidobacterium combined with Yinzhihuang can effectively shorten the time of the regression of jaundice symptoms and improve the TCB level. The recurrence rate after treatment is low， and the side effects will not be increased. The treatment effect is good and worth promoting.
新生兒黄疸属于新生儿期常见病，主要因胆红素于体内累积引起皮肤、其他器官黄染，由于新生儿体内有丰富的毛细血管，一旦血清总胆红素水平超过5～7 mg/dl，便会有肉眼可见黄疸出现，新生儿黄疸最常见表现形式为未结合胆红素增高，绝大多数新生儿黄疸属于生理性，仅有少部分是病理性，病理性黄疸若病情严重可能会诱发胆红素脑病，永久性损害新生儿神经系统，甚至出现死亡的严重后果[1-2]。而生理性黄疸能够在新生期内自愈，不会损伤新生儿身体健康[3]。本研究选择以间接胆红素升高为主，肝功能正常，乙肝表面抗原阴性，肝胆彩超正常，无感染因素存在，血常规及网织红细胞计数均在正常范围内，无胆汁排泄障碍及代谢性疾病的新生儿黄疸患儿，给予双歧杆菌三联活菌散、茵栀黄口服联合治疗，探究对临床治疗效果的影响，现报道如下。
1 资料与方法
1.1 一般资料
本次126例研究对象均为2017年5月-2018年9月笔者所在医院接收的黄疸新生儿，均明确诊断为病理性黄疸新生儿，有《实用新生儿科》中新生儿黄疸诊断标准为参考，均符合诊断病理性黄疸标准。纳入标准：足月新生儿(孕周≥37周，且<42周)出生后3～10 d，黄疸在出生后48 h～5 d内出现;总胆红素在220～250 μmol/L，直接胆红素均<34.2 μmol/L，谷丙转氨酶正常，无感染因素存在，一般情况好。排除标准：(1)患有先天畸形、先天性白内障、先天性心脏病等先天性疾病的患儿;(2)对双歧杆菌三联活菌散、茵栀黄口服液药物过敏的患儿;(3)患有血液系统疾病、肾性疾病、肺炎等疾病的患儿;(4)ABO溶血及Rh溶血，无核黄疸的早期临床表现[4-5]。将其随机分为治疗组(66例)、对照组(60例)。对照组男33例，女27例;日龄6～27 d，平均(16.54±3.57)d;孕周37～41周，平均(39.07±0.74)周;出生体重2.4～4.5 kg，平均(3.56±0.48)kg。治疗组男35例，女31例;日龄7～28 d，平均(17.52±3.56)d;孕周38～41周，平均(40.06±0.72)周;出生体重2.5～4.6 kg，平均(3.64±0.45)kg。两组出生孕周、年龄、体重、性别等一般资料比较，差异无统计学意义(P>0.05)。, 百拇医药(许建章 郑津津 关素琴)
【关键词】 黄疸 新生儿 双歧杆菌 茵栀黄 治疗效果
[Abstract] Objective： To analyze the clinical value of Yinzhihuang combined with Bifidobacterium in the treatment of neonatal jaundice. Method： From May 2017 to September 2018， 126 neonates with jaundice received in the pediatrics department of our hospital were selected and randomly divided into the control group (60 cases) and the treatment group (60 cases). Children in the control group were treated with Yinzhihuang， while children in the treatment group were treated with Yinzhihuang combined with Bifidobacterium. The therapeutic effect of the two groups was compared. Result： The total effective rate of the treatment group was significantly higher than that of the control group， and the difference was statistically significant (P<0.05). After treatment， the decrease value of TCB in the treatment group at 72 h and the average daily value of TCB in the control group were significantly higher than those in the control group， the differences were statistically significant (P<0.05). The regression time of jaundice in the treatment group was shorter than that in the control group， and the recurrence rate was lower than that in the control group， the differences were statistically significant (P<0.05). Conclusion： The clinical treatment of neonatal jaundice with Bifidobacterium combined with Yinzhihuang can effectively shorten the time of the regression of jaundice symptoms and improve the TCB level. The recurrence rate after treatment is low， and the side effects will not be increased. The treatment effect is good and worth promoting.
新生兒黄疸属于新生儿期常见病，主要因胆红素于体内累积引起皮肤、其他器官黄染，由于新生儿体内有丰富的毛细血管，一旦血清总胆红素水平超过5～7 mg/dl，便会有肉眼可见黄疸出现，新生儿黄疸最常见表现形式为未结合胆红素增高，绝大多数新生儿黄疸属于生理性，仅有少部分是病理性，病理性黄疸若病情严重可能会诱发胆红素脑病，永久性损害新生儿神经系统，甚至出现死亡的严重后果[1-2]。而生理性黄疸能够在新生期内自愈，不会损伤新生儿身体健康[3]。本研究选择以间接胆红素升高为主，肝功能正常，乙肝表面抗原阴性，肝胆彩超正常，无感染因素存在，血常规及网织红细胞计数均在正常范围内，无胆汁排泄障碍及代谢性疾病的新生儿黄疸患儿，给予双歧杆菌三联活菌散、茵栀黄口服联合治疗，探究对临床治疗效果的影响，现报道如下。
1 资料与方法
1.1 一般资料
本次126例研究对象均为2017年5月-2018年9月笔者所在医院接收的黄疸新生儿，均明确诊断为病理性黄疸新生儿，有《实用新生儿科》中新生儿黄疸诊断标准为参考，均符合诊断病理性黄疸标准。纳入标准：足月新生儿(孕周≥37周，且<42周)出生后3～10 d，黄疸在出生后48 h～5 d内出现;总胆红素在220～250 μmol/L，直接胆红素均<34.2 μmol/L，谷丙转氨酶正常，无感染因素存在，一般情况好。排除标准：(1)患有先天畸形、先天性白内障、先天性心脏病等先天性疾病的患儿;(2)对双歧杆菌三联活菌散、茵栀黄口服液药物过敏的患儿;(3)患有血液系统疾病、肾性疾病、肺炎等疾病的患儿;(4)ABO溶血及Rh溶血，无核黄疸的早期临床表现[4-5]。将其随机分为治疗组(66例)、对照组(60例)。对照组男33例，女27例;日龄6～27 d，平均(16.54±3.57)d;孕周37～41周，平均(39.07±0.74)周;出生体重2.4～4.5 kg，平均(3.56±0.48)kg。治疗组男35例，女31例;日龄7～28 d，平均(17.52±3.56)d;孕周38～41周，平均(40.06±0.72)周;出生体重2.5～4.6 kg，平均(3.64±0.45)kg。两组出生孕周、年龄、体重、性别等一般资料比较，差异无统计学意义(P>0.05)。, 百拇医药(许建章 郑津津 关素琴)
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