Efficacy of simultaneous peripheral arteriovenous exchange transfusion combined with intermittent blue light in the treatment of severe hyperbilirubinemia in neonates and its influence on cerebral electrical activity
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目的 探究外周动静脉同步换血联合间歇蓝光治疗新生儿重度高胆红素血症的效果及对脑电活动的影响。 方法 随机对照研究。抽取2020年2月至2023年2月郑州大学附属儿童医院收治的高胆红素血症患儿86例，根据蓝光治疗方案分为对照组(46例)和研究组(40例)。两组均接受外周动静脉同步换血，对照组接受持续蓝光治疗，研究组接受间歇蓝光治疗。比较两组治疗前后血清胆红素水平、脑电活动情况及不良反应发生情况。 结果 治疗后，两组患儿血清总胆红素、间接胆红素水平低于治疗前(P<0.05)，但两组上述指标水平比较差异未见统计学意义(P>0.05)。治疗后，两组痫性放电者比例与治疗前比较，差异未见统计学意义(P>0.05)；治疗后，对照组脑电背景活动异常者比例与治疗前比较，差异未见统计学意义(P>0.05)，研究组脑电背景活动重度抑制者比例少于治疗前(χ2＝7.21，P＝0.007)；治疗后，对照组睡眠-觉醒周期成熟者比例高于治疗前(χ2＝3.87，P＝0.049)，研究组睡眠-觉醒周期缺失者比例少于治疗前(χ2＝7.21，P＝0.007)。两组治疗前及治疗后脑电活动分布情况比较，差异未见统计学意义(P>0.05)。研究组不良反应总发生率(25.00%，10/40)低于对照组(65.22%，30/46)，P<0.05。 结论 外周动静脉同步换血联合间歇蓝光治疗新生儿重度高胆红素血症，能有效降低血胆红素水平，改善脑电活动，降低不良反应发生率。 Objective To investigate the efficacy of simultaneous peripheral arteriovenous exchange transfusion combined with intermittent blue light in the treatment of severe hyperbilirubinemia in neonates, and the influence on cerebral electrical activity. Methods This study was a randomized controlled trial.A total of 86 children with hyperbilirubinemia admitted to Children’s Hospital Affiliated of Zhengzhou University from February 2020 to February 2023 were selected, and they were divided into control group (46 cases) and study group (40 cases) according to the blue light treatment plan. The two groups received simultaneous peripheral arteriovenous exchange transfusion the control group received continuous blue light therapy, and the study group received intermittent blue light therapy. The preoperative and postoperative level of serum bilirubin, cerebral electrical activity and incidence of adverse reactions of the two groups were compared. Results After treatment, the levels of serum total bilirubin and indirect bilirubin in the two groups were lower than those before treatment (P<0.05), but there was no significant difference in the levels of the above indexes between the two groups (P>0.05). After treatment, there was no significant difference in comparison of preoperative and postoperative proportion of patients with epileptic discharges in the two groups (P>0.05). After treatment, there was no significant difference in comparison of preoperative and postoperative proportion of patients with abnormal background electroencephalogram activity in the control group (P>0.05). After treatment, the proportion of patients with severe suppression of background electroencephalogram activity in the study group was less than that before treatment (χ2=7.21, P=0.007). After treatment, the proportion of patients with mature sleep-wake cycle in the control group was higher than that before treatment (χ2=3.87, P=0.049), and the proportion of patients with sleep-wake cycle loss in the study group was less than that before treatment (χ2=7.21, P=0.007). There was no significant difference in the distribution of electroencephalogram activity between the two groups before and after treatment (P>0.05). The total incidence of adverse reactions in the study group(25.00%, 10/40) was lower than that in the control group (65.22%, 30/46),P<0.05. Conclusions Simultaneous peripheral arteriovenous exchange transfusion combined with intermittent blue light in the treatment of severe neonatal hyperbilirubinemia can effectively reduce levels of blood bilirubin, improve cerebral electrical activity, and reduce the incidence of adverse reactions.
Objective To investigate the efficacy of simultaneous peripheral arteriovenous exchange transfusion combined with intermittent blue light in the treatment of severe hyperbilirubinemia in neonates, and the influence on cerebral electrical activity. Methods This study was a randomized controlled trial.A total of 86 children with hyperbilirubinemia admitted to Children’s Hospital Affiliated of Zhengzhou University from February 2020 to February 2023 were selected, and they were divided into control group (46 cases) and study group (40 cases) according to the blue light treatment plan. The two groups received simultaneous peripheral arteriovenous exchange transfusion the control group received continuous blue light therapy, and the study group received intermittent blue light therapy. The preoperative and postoperative level of serum bilirubin, cerebral electrical activity and incidence of adverse reactions of the two groups were compared. Results After treatment, the levels of serum total bilirubin and indirect bilirubin in the two groups were lower than those before treatment (P<0.05), but there was no significant difference in the levels of the above indexes between the two groups (P>0.05). After treatment, there was no significant difference in comparison of preoperative and postoperative proportion of patients with epileptic discharges in the two groups (P>0.05). After treatment, there was no significant difference in comparison of preoperative and postoperative proportion of patients with abnormal background electroencephalogram activity in the control group (P>0.05). After treatment, the proportion of patients with severe suppression of background electroencephalogram activity in the study group was less than that before treatment (χ2=7.21, P=0.007). After treatment, the proportion of patients with mature sleep-wake cycle in the control group was higher than that before treatment (χ2=3.87, P=0.049), and the proportion of patients with sleep-wake cycle loss in the study group was less than that before treatment (χ2=7.21, P=0.007). There was no significant difference in the distribution of electroencephalogram activity between the two groups before and after treatment (P>0.05). The total incidence of adverse reactions in the study group(25.00%, 10/40) was lower than that in the control group (65.22%, 30/46),P<0.05. Conclusions Simultaneous peripheral arteriovenous exchange transfusion combined with intermittent blue light in the treatment of severe neonatal hyperbilirubinemia can effectively reduce levels of blood bilirubin, improve cerebral electrical activity, and reduce the incidence of adverse reactions.
Hyperbilirubinemia, neonatalSimultaneous peripheral arteriovenous exchange transfusionIntermittent blue light
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