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目的探讨早期干预早产儿黄疸的疗效和对肠外营养及体质量增长的影响。方法174例早产儿,出生体质量1500～2000g者(A组)87例,出生体质量<1500g者(B组)87例,分别按常规干预和早期干预分组。常规组血清总胆红素(TSB)达干预推荐方案的标准时光疗,早期组于出现黄疸,但TSB未达干预标准即光疗。结果A、B组的早期组胆红素峰值(PSB)均低于常规组[A组:(209.48±38.99)μmol/L和(266.59±37.11)μmol/L,B组:(180.23±31.63)μmol/L和(243.68±37.45)μmol/L,P均<0.05];早期组与常规组相比黄疸消退日龄早[A组:(14.5±4.4)d和(18.0±3.8)d,B组:(10.8±3.0)d和(18.8±5.5)d,P均<0.05],脂肪乳起始日龄早[A组:(5.8±2.7)d和(8.1±3.7)d,P>0.05;B组:(3.8±1.8)d和(9.2±4.4)d,P<0.05],恢复出生体质量日龄早[A组:(13.1±6.0)d和(14.4±4.0)d,P>0.05;B组:(9.3±4.8)d和(15.4±5.6)d,P<0.05]。结论早期干预可以使早产儿尤其是极低出生体重儿PSB降低,黄疸持续时间缩短,利于早期添加脂肪乳和早产儿体质量增长。
Objective To investigate the effect of early intervention on jaundice in preterm infants and the effect on parenteral nutrition and body weight. Methods A total of 174 premature infants were enrolled, 87 with birth weight of 1500-2000g (group A) and 87 with birth weight <1500g (group B). The patients were divided into two groups according to routine and early intervention. The routine group of serum total bilirubin (TSB) up to the standard time of intervention recommended program, the early group appeared in jaundice, but TSB did not reach the standard of intervention that phototherapy. Results The peak bilirubin peak (PSB) in group A and group B were significantly lower than those in group A [(209.48 ± 38.99) μmol / L and (266.59 ± 37.11) μmol / L in group B and (180.23 ± 31.63) (14.5 ± 4.4) days and (18.0 ± 3.8) days, B (P <0.05). Compared with the conventional group, the early days of jaundice subsided Group: (10.8 ± 3.0) days and (18.8 ± 5.5) days, all P <0.05] ; Group B: (3.8 ± 1.8) days and (9.2 ± 4.4) days, P <0.05] 0.05; Group B: (9.3 ± 4.8) days and (15.4 ± 5.6) days, P <0.05]. Conclusion Early intervention can reduce the PSB in preterm infants, especially in very low birth weight infants, and shorten the duration of jaundice, which is beneficial to the early increase of body weight of fat emulsion and premature infants.