目的 探讨苯巴比妥、熊去氧胆酸治疗新生儿胆汁淤积症的临床效果.方法 选择2017年5月至2018年6月在我院接受治疗的胆汁淤积症新生儿, 共72例, 分为2组, 给予对照组患儿 (36例) 苯巴比妥+蓝光照射治疗, 在此基础上给予观察组患儿 (36例) 熊去氧胆酸治疗.观察患儿肝功能指标、血清胆红素、不良反应情况.结果 治疗后, 观察组患儿γ-GGT、AST、ALT、DBIL、TBIL水平均低于对照组 (P <0. 05) ;观察组黄疸指数为 (12. 26±3. 27) mg/dl, 显著低于对照组的 (16. 80±3. 62) mg/dl (P <0. 05) ;观察组患儿日排便次数多于对照组, 且胎便初排及转黄时间较对照组缩短 (P <0. 05) .观察组的治疗总有效率高于对照组 (94. 44％vs.77. 78％, P <0. 05) .两组患者均未出现严重不良反应, 不良反应发生率均为13. 89％.结论 熊去氧胆酸、苯巴比妥在新生儿胆汁淤积症的治疗中, 可使患儿肝功能获得更大程度改善, 降低血清胆红素浓度, 促进患儿主要临床症状获得更快缓解, 提高总体疗效, 且不会引起严重不良反应, 安全性良好.%Objective To evaluate the clinical efficacy of phenobarbital and ursodeoxycholic acid in the treatment of neonatal cholestasis. Methods Totally 72 neonates with cholestasis treated in our hospital from M ay 2017 to June 2018 were divided into 2 groups. Control group (n = 36) was treated with phenobarbital combined with blue light irradiation; in addition, observation group (n = 36) was also treated with ursodeoxycholic acid. The indexes of liver function, serum bilirubin and adverse reactions were observed. Results After treatment, the levels of gamma-GGT, AST, ALT, DBIL and TBIL in observation group were lower than those in control group (P < 0. 05) ; the jaundice index of observation group was lower than that of control group [ (12. 26 ± 3. 27) mg/dl vs. (16. 80 ± 3. 62) mg/dl, P <0. 05) ; the daily frequency of defecation in observation group was more than that of control group, while the time of first defecation and turning yellowof meconium was shorter than that of control group (P < 0. 05) ; the total effective rate of observation group was higher than that of control group (94. 44％ vs. 77. 78％, P < 0. 05) . No serious adverse reaction was found in the two groups, whose incidence rate of each group was 13. 89％. Conclusion Ursodeoxycholic acid and phenobarbital can improve the liver function of children with neonatal cholestasis, reduce the concentration of serum bilirubin, and promote the relief of main clinical symptoms, which can improve the overall efficacy with good safety.
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