目的 系统评价不同蓝光治疗模式对新生儿高胆红素血症的疗效及不良反应,为临床治疗提供科学依据。方法 检索PubMed、EMBASE、Web of Science、Cochrane library、中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、万方数据库等数据库中有关蓝光治疗新生儿高胆红素血症临床随机对照研究,检索时限为建库之日起至2018年5月。文献数据统一采用RevMan 5.3 软件进行分析。无法进行Meta分析的指标,则进行相关统计学分析。结果 总共纳入8 篇文献,954 例患儿。Meta分析结果显示,蓝光治疗可以降低高胆红素血症患儿的血清胆红素浓度(SMD=55.35, 95%CI:50.23～60.48, P<0.001),差异具有统计学意义。其中间歇性照射治疗后的血清胆红素浓度分析结果为(SMD=58.72,95%CI:54.35～63.09, P<0.001),连续性照射治疗后的血清胆红素浓度分析结果为(SMD=51.53,95%CI:41.48～61.59, P<0.001),差异均具有统计学意义。不同蓝光治疗模式对高胆红素血症患儿的治愈率(χ2=0.00,P=1.00)和血清胆红素浓度的降低程度(SMD=-1.24,95%CI:-5.62～3.15,P=0.58)的差异无统计学意义。与连续性照射治疗相比较,间歇性照射治疗的不良反应发生率更低(RR=0.18,95%CI:0.13～0.25,P<0.001)。结论 间歇性与连续性蓝光治疗均能有效的降低高胆红素血症患儿的血清胆红素浓度,其中间歇性照射治疗比连续性照射治疗能够更好的减少患儿不良反应发生。
Abstract
Objective To evaluate the efficacy and adverse reactions of different blue phototherapy modes on neonatal hyperbilirubinemia,in order to provide scientific evidence for clinical treatment. Methods The clinical randomized controlled study on the treatment of neonatal hyperbilirubinemia by blue phototherapy published from the database inception to May 2018,were retrieved in PubMed,EMBASE,Web of science,Cochrane library,CNKI,VIP and WanFang database. Most literature results were analyzed by RevMan 5.3,but some results were dealt by other medical statistics methods. Results Finally 8 literature containing 954 patients were selected. Meta-analysis showed that phototherapy can significantly decrease the infants′ serum bilirubin level (SMD=55.35,95%CI:50.23-60.48, P<0.001),of which both intermittent phototherapy and continuous phototherapy can also decrease the infants′ serum bilirubin concentration (SMD=58.72,95%CI:54.35～63.09, P<0.001;SMD=51.53,95%CI:41.48～ 61.59, P<0.001). However,the differences on cure rate of neonatal hyperbilirubinemia (χ2=0.00,P=1.00) and the decrease value of the serum bilirubin concentration (SMD=-1.24,95%CI:-5.62-3.15,P=0.58) between different blue phototherapy modes were not significant. Compared with continuous phototherapy,intermittent phototherapy showed lower rate of adverse reactions (RR=0.18,95%CI :0.13-0.25,P<0.001). Conclusions Both intermittent phototherapy and continuous phototherapy can effectively decrease the infants′ serum bilirubin concentration. Meanwhile,the intermittent phototherapy can better reduce the incidence of adverse reactions than continuous phototherapy.
关键词
蓝光治疗 /
血清胆红素 /
不良反应 /
Meta分析
Key words
blue phototherapy /
bilirubin /
adverse reaction /
Meta-analysis
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